Implementación de sistema de gestión de la calidad en la empresa Krear GIP

El objetivo del proyecto fue la Formulación del Proyecto para la implementación de un Sistema de Gestión de Calidad en la empresa Krear GIP, ubicada en la ciudad de Yopal; perdió clientes debido a las fallas en los procesos. Este proyecto utilizó la investigación de campo como método de investigación y usos del análisis contextual, entrevistas, reuniones y documentales. revisar como herramientas para la recopilación de información; Para obtener los datos necesarios que permitieron. ejecutar las cinco fases de la implementación, involucrando constantemente a las partes interesadas de El proyecto y garantizando su sostenibilidad. De esta manera, la empresa logró la La implementación del SGC de una manera exitosa, porque los clientes se incrementaron, se contrató más personal de trabajo, se incrementaron los ingresos y una mayor participación en Se obtuvo el mercado de la consultaría

Brote de rabia urbana transmitida por perros en el distrito de Santa Marta, Colombia, 2006-2008

Introduction. An urban rabies outbreak occurred in the District of Santa Marta between April 2006 and January 2008, which resulted in the deaths of 4 humans and 28 dogs.Objectives. Three objectives were entertained—first, the diagnostic laboratory techniques were described as well as the rabies control actions taken; second, the impact of anti-rabies dog vaccination was assessed in terms of neutralizing antibody seroconversion; and third, the epidemiological significance and public health implications of the outbreak were examined.Materials and methods. Rabies diagnosis was achieved by direct immunofluorescence, inoculation of mice and immunohistochemistry. Typing of the virus was achieved by indirect immunofluorescence. Control activities included a dog population census, vaccination and treatments for persons exposed to rabies, mass vaccination of dogs and cats, and initiation of a community education program. Seroconversion was investigated by capture ELISA.Results. Antigenic variant 1 was detected in all cases. Of vaccinated dogs, 77% were seropositive,and 47% were seroprotected against rabies. No differences were found in the humoral response between dog gender; however significant differences in dog seroprotection were discovered between localized comunities in Santa Marta.Conclusions. The 2006-2008 urban rabies outbreak was the largest reported in a city in Colombia. It was caused by rabid dogs, and demonstrated that these animals are still a threat for human health despite the existence of efficient rabies vaccines. The control of the outbreak was achieved 20 months after the first rabies case in dogs, and 14 months after the initiation of the first mass vaccination of animals. The necessity of implementation and maintenance of rabies control strategies is underlined for minimizing human risk.Introducción. En el distrito de Santa Marta ocurrió un brote de rabia urbana entre abril de 2006 y enero de 2008, con cuatro casos fatales en humanos y 28 en perros.Objetivos. Describir el brote, las técnicas de diagnóstico de laboratorio y las acciones de control de foco empleadas. Medir el impacto de la vacunación antirrábica canina en términos de seroconversión de anticuerpos neutralizantes. Discutir el significado epidemiológico y las implicaciones en salud pública.Materiales y métodos. Los casos se diagnosticaron por inmunofluorescencia directa, prueba biológica en ratón e inmunohistoquímica. La tipificación viral se hizo por inmunofluorescencia indirecta. Las acciones de control consistieron en un censo canino, vacunación y tratamientos antirrábicos a la población expuesta, vacunación canina y felina, y educación comunitaria. La seroconversión fue investigada por medio de la prueba ELISA de captura.Resultados. La variante antigénica 1 se caracterizó en todos los casos. Se observó seropositividad en 77% de los perros vacunados y protección serológica contra la rabia, en 47%. No se observaron diferencias de la respuesta humoral entre sexos de los perros, pero sí existieron diferencias de los porcentajes de perros protegidos entre las comunas del distrito.Conclusiones. Este brote de rabia ha sido el de mayor magnitud en una ciudad colombiana, según los datos oficiales. Fue causado por perros, lo cual reitera la amenaza que aún representa la rabia urbana para la salud pública, a pesar de la existencia de vacunas eficientes.El control del brote se logró 20 meses después del primer caso en perros y 14 meses después de haberse iniciado la primera vacunación masiva en animales. Es necesario implementar y mantener acciones para el control de la rabia urbana y evitar su impacto en los humanos

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Valoración y unificación de criterios de diseño de pavimentos de vías internas de proyectos de viviendas de interés social o prioritario

La monografía que se desarrolló a continuación tuvo como objetivo principal. Ofrecer una solución para la disminución en costos para la construcción de vías internas de vivienda de interés social o prioritaria. Para el desarrollo del tema de este estudio, se hizo de la siguiente forma: Se planteó cuales son los problemas que influyen en los altos costos en la construcción de vías internas de vivienda de interés social. Se hizo un estudio de marco teórico, en el cual se estudiaron las variables mas importantes para el diseño de pavimentos flexible, rígidos y articulados. Conociendo las variables para el diseño de pavimentos, se verificara cual es que tiene mayor ingerencia en ellos. Se determinó durante el estudio que la variable mas importante a considerar es el transito, para el cual se hicieron estudios y consideraciones de comportamiento en uno de los proyectos mas representativos (Ciudadela el Recreo), actualmente uno de los proyectos mas importantes, en soluciones de vivienda para las familias menos favorecidas económicamente. También, se fueron analizados los sistema de diseño de pavimentos utilizados actualmente. Encontrándose falencias para ser utilizados en proyectos donde una de las mas importantes prioridades es la economía. Con los estudios hechos de transito, se prosiguió a empalmar en Excel con los sistemas de diseño de pavimentos convencionales, tales como Aashto, P.C.A. y el sitema de diseño para pavimento flexibles por el método de Jhon Knapton. Promocionándose una herramienta para el diseño de pavimentos flexibles, rígidos y articulados para vías internas de vivienda de interés social y prioritaria, de fácil utilización. Ante la necesidad de poseer una herramienta de fácil manejo sin necesidad de tener un computador a la mano, se hicieron una serie de diseños de pavimentos flexibles y rígidos, con el fin de parametrizar el comportamiento de los diseños de pavimentos, para el caso de pavimentos flexibles se proporciono un ábaco de diseño y para el pavimento rígido se suministro unas tablas de diseño, con los cuales pueden ser diseñados los espesores mínimos de cualquier tipo de pavimentos para vías internas de vivienda de interés social. Posteriormente se realizo un ejemplo, en el cual se pusieron en practica los sistemas actuales de diseño y el diseño de pavimentos con los parámetros sugeridos durante este estudio. A continuación se hicieron presupuestos de los diferentes diseños, se compararon los resultados tanto económica como técnicamente. Donde los resultados fueron favorables para el diseño propuesto por este estudio. Posteriormente se extrajeron conclusiones y recomendaciones

Estimating and mapping the incidence of giardiasis in Colombia, 2009–2013

Background: Giardiasis is one of the most common intestinal infections in the world. There have been no national studies on the morbidity of giardiasis in Colombia. In this study, incidence rates of giardiasis were estimated for the years 2009–2013. Methods: An observational, retrospective study of the giardiasis incidence in Colombia, 2009–2013, was performed using data extracted from the personal health records system (Registro Individual de Prestación de Servicios, RIPS). Official population estimates from the National Department of Statistics (DANE) were used for the estimation of crude and adjusted incidence rates (cases/100 000 population). Results: During the period studied, 15 851 cases were reported (median 3233/year; 5-year cumulated crude national rate of 33.97 cases/100 000 population). Of these, 50.3% were female; 58.4% were <10 years old and 14.8% were 10–19 years old. By region, 17.7% were from Bogotá (10.07 cases/100 000 population, 2009), 10.9% from Antioquia (9.42, 2009), 8.6% from Atlántico (15.67, 2009), and 6.5% from Risaralda (33.38, 2009). Cases were reported in all departments (even insular areas). Conclusions: As giardiasis is neglected in many countries, surveillance is not regularly undertaken. Despite its limitations, this study is the first attempt to provide estimates of national giardiasis incidence with consistent findings regarding affected age groups and geographical distribution

Libro de Proyectos Finales 2021 primer semestre

PregradoIngeniero CivilIngeniero de SistemasIngeniero ElectricistaIngeniero ElectrónicoIngeniero IndustrialIngeniero Mecánic

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

GWAS and meta-analysis identifies 49 genetic variants underlying critical COVID-19

Data availability: Downloadable summary data are available through the GenOMICC data site (https://genomicc.org/data). Summary statistics are available, but without the 23andMe summary statistics, except for the 10,000 most significant hits, for which full summary statistics are available. The full GWAS summary statistics for the 23andMe discovery dataset will be made available through 23andMe to qualified researchers under an agreement with 23andMe that protects the privacy of the 23andMe participants. For further information and to apply for access to the data, see the 23andMe website (https://research.23andMe.com/dataset-access/). All individual-level genotype and whole-genome sequencing data (for both academic and commercial uses) can be accessed through the UKRI/HDR UK Outbreak Data Analysis Platform (https://odap.ac.uk). A restricted dataset for a subset of GenOMICC participants is also available through the Genomics England data service. Monocyte RNA-seq data are available under the title ‘Monocyte gene expression data’ within the Oxford University Research Archives (https://doi.org/10.5287/ora-ko7q2nq66). Sequencing data will be made freely available to organizations and researchers to conduct research in accordance with the UK Policy Framework for Health and Social Care Research through a data access agreement. Sequencing data have been deposited at the European Genome–Phenome Archive (EGA), which is hosted by the EBI and the CRG, under accession number EGAS00001007111.Extended data figures and tables are available online at https://www.nature.com/articles/s41586-023-06034-3#Sec21 .Supplementary information is available online at https://www.nature.com/articles/s41586-023-06034-3#Sec22 .Code availability: Code to calculate the imputation of P values on the basis of SNPs in linkage disequilibrium is available at GitHub (https://github.com/baillielab/GenOMICC_GWAS).Acknowledgements: We thank the members of the Banco Nacional de ADN and the GRA@CE cohort group; and the research participants and employees of 23andMe for making this work possible. A full list of contributors who have provided data that were collated in the HGI project, including previous iterations, is available online (https://www.covid19hg.org/acknowledgements).Change history: 11 July 2023: A Correction to this paper has been published at: https://doi.org/10.1038/s41586-023-06383-z. -- In the version of this article initially published, the name of Ana Margarita Baldión-Elorza, of the SCOURGE Consortium, appeared incorrectly (as Ana María Baldion) and has now been amended in the HTML and PDF versions of the article.Copyright © The Author(s) 2023, Critical illness in COVID-19 is an extreme and clinically homogeneous disease phenotype that we have previously shown1 to be highly efficient for discovery of genetic associations2. Despite the advanced stage of illness at presentation, we have shown that host genetics in patients who are critically ill with COVID-19 can identify immunomodulatory therapies with strong beneficial effects in this group3. Here we analyse 24,202 cases of COVID-19 with critical illness comprising a combination of microarray genotype and whole-genome sequencing data from cases of critical illness in the international GenOMICC (11,440 cases) study, combined with other studies recruiting hospitalized patients with a strong focus on severe and critical disease: ISARIC4C (676 cases) and the SCOURGE consortium (5,934 cases). To put these results in the context of existing work, we conduct a meta-analysis of the new GenOMICC genome-wide association study (GWAS) results with previously published data. We find 49 genome-wide significant associations, of which 16 have not been reported previously. To investigate the therapeutic implications of these findings, we infer the structural consequences of protein-coding variants, and combine our GWAS results with gene expression data using a monocyte transcriptome-wide association study (TWAS) model, as well as gene and protein expression using Mendelian randomization. We identify potentially druggable targets in multiple systems, including inflammatory signalling (JAK1), monocyte–macrophage activation and endothelial permeability (PDE4A), immunometabolism (SLC2A5 and AK5), and host factors required for viral entry and replication (TMPRSS2 and RAB2A).GenOMICC was funded by Sepsis Research (the Fiona Elizabeth Agnew Trust), the Intensive Care Society, a Wellcome Trust Senior Research Fellowship (to J.K.B., 223164/Z/21/Z), the Department of Health and Social Care (DHSC), Illumina, LifeArc, the Medical Research Council, UKRI, a BBSRC Institute Program Support Grant to the Roslin Institute (BBS/E/D/20002172, BBS/E/D/10002070 and BBS/E/D/30002275) and UKRI grants MC_PC_20004, MC_PC_19025, MC_PC_1905 and MRNO2995X/1. A.D.B. acknowledges funding from the Wellcome PhD training fellowship for clinicians (204979/Z/16/Z), the Edinburgh Clinical Academic Track (ECAT) programme. This research is supported in part by the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant MC_PC_20029). Laboratory work was funded by a Wellcome Intermediate Clinical Fellowship to B.F. (201488/Z/16/Z). We acknowledge the staff at NHS Digital, Public Health England and the Intensive Care National Audit and Research Centre who provided clinical data on the participants; and the National Institute for Healthcare Research Clinical Research Network (NIHR CRN) and the Chief Scientist’s Office (Scotland), who facilitate recruitment into research studies in NHS hospitals, and to the global ISARIC and InFACT consortia. GenOMICC genotype controls were obtained using UK Biobank Resource under project 788 funded by Roslin Institute Strategic Programme Grants from the BBSRC (BBS/E/D/10002070 and BBS/E/D/30002275) and Health Data Research UK (HDR-9004 and HDR-9003). UK Biobank data were used in the GSMR analyses presented here under project 66982. The UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Assembly Government, British Heart Foundation and Diabetes UK. The work of L.K. was supported by an RCUK Innovation Fellowship from the National Productivity Investment Fund (MR/R026408/1). J.Y. is supported by the Westlake Education Foundation. SCOURGE is funded by the Instituto de Salud Carlos III (COV20_00622 to A.C., PI20/00876 to C.F.), European Union (ERDF) ‘A way of making Europe’, Fundación Amancio Ortega, Banco de Santander (to A.C.), Cabildo Insular de Tenerife (CGIEU0000219140 ‘Apuestas científicas del ITER para colaborar en la lucha contra la COVID-19’ to C.F.) and Fundación Canaria Instituto de Investigación Sanitaria de Canarias (PIFIISC20/57 to C.F.). We also acknowledge the contribution of the Centro National de Genotipado (CEGEN) and Centro de Supercomputación de Galicia (CESGA) for funding this project by providing supercomputing infrastructures. A.D.L. is a recipient of fellowships from the National Council for Scientific and Technological Development (CNPq)-Brazil (309173/2019-1 and 201527/2020-0)