Propuesta de un sistema de Gestión de la calidad en el proceso de elaboración de muebles para la Mueblería. El Guegüense ubicada en la carretera Niquinohomo – Masatepe

Presenta una propuesta de un sistema de gestión de la calidad en el proceso de elaboración de muebles para la mueblería El Guegüense ubicada en la carretera Niquinohomo - Masatepe. Describe un análisis de la situación actual respecto a la calidad en el proceso de elaboración de los productos en la mueblería. Propone la elaboración de fichas de proceso para cada una de las etapas del proceso de elaboración de muebles. Presenta una guía de mejora en el proceso de secado al aire libre; Un plan de capacitación en materia de calidad para el personal de producción. Una guía para implementar medidas de seguridad e higiene ocupacional

Unusual Dengue Virus 3 Epidemic in Nicaragua, 2009

The four dengue virus serotypes (DENV1–4) cause the most prevalent mosquito-borne viral disease affecting humans worldwide. In 2009, Nicaragua experienced the largest dengue epidemic in over a decade, marked by unusual clinical presentation, as observed in two prospective studies of pediatric dengue in Managua. From August 2009–January 2010, 212 dengue cases were confirmed among 396 study participants at the National Pediatric Reference Hospital. In our parallel community-based cohort study, 170 dengue cases were recorded in 2009–10, compared to 13–65 cases in 2004–9. In both studies, significantly more patients experienced “compensated shock” (poor capillary refill plus cold extremities, tachycardia, tachypnea, and/or weak pulse) in 2009–10 than in previous years (42.5% [90/212] vs. 24.7% [82/332] in the hospital study (p<0.001) and 17% [29/170] vs. 2.2% [4/181] in the cohort study (p<0.001). Signs of poor peripheral perfusion presented significantly earlier (1–2 days) in 2009–10 than in previous years according to Kaplan-Meier survival analysis. In the hospital study, 19.8% of subjects were transferred to intensive care, compared to 7.1% in previous years – similar to the cohort study. DENV-3 predominated in 2008–9, 2009–10, and 2010–11, and full-length sequencing revealed no major genetic changes from 2008–9 to 2010–11. In 2008–9 and 2010–11, typical dengue was observed; only in 2009–10 was unusual presentation noted. Multivariate analysis revealed only “2009–10” as a significant risk factor for Dengue Fever with Compensated Shock. Interestingly, circulation of pandemic influenza A-H1N1 2009 in Managua was shifted such that it overlapped with the dengue epidemic. We hypothesize that prior influenza A H1N1 2009 infection may have modulated subsequent DENV infection, and initial results of an ongoing study suggest increased risk of shock among children with anti-H1N1-2009 antibodies. This study demonstrates that parameters other than serotype, viral genomic sequence, immune status, and sequence of serotypes can play a role in modulating dengue disease outcome

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity &gt; 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Co-limitation towards lower latitudes shapes global forest diversity gradients

The latitudinal diversity gradient (LDG) is one of the most recognized global patterns of species richness exhibited across a wide range of taxa. Numerous hypotheses have been proposed in the past two centuries to explain LDG, but rigorous tests of the drivers of LDGs have been limited by a lack of high-quality global species richness data. Here we produce a high-resolution (0.025° × 0.025°) map of local tree species richness using a global forest inventory database with individual tree information and local biophysical characteristics from ~1.3 million sample plots. We then quantify drivers of local tree species richness patterns across latitudes. Generally, annual mean temperature was a dominant predictor of tree species richness, which is most consistent with the metabolic theory of biodiversity (MTB). However, MTB underestimated LDG in the tropics, where high species richness was also moderated by topographic, soil and anthropogenic factors operating at local scales. Given that local landscape variables operate synergistically with bioclimatic factors in shaping the global LDG pattern, we suggest that MTB be extended to account for co-limitation by subordinate drivers

G6PD deficiency in Latin America: systematic review on prevalence and variants

Plasmodium vivax radical cure requires the use of primaquine (PQ), a drug that induces haemolysis in glucose-6-phosphate dehydrogenase deficient (G6PDd) individuals, which further hampers malaria control efforts. The aim of this work was to study the G6PDd prevalence and variants in Latin America (LA) and the Caribbean region. A systematic search of the published literature was undertaken in August 2013. Bibliographies of manuscripts were also searched and additional references were identified. Low prevalence rates of G6PDd were documented in Argentina, Bolivia, Mexico, Peru and Uruguay, but studies from Curaçao, Ecuador, Jamaica, Saint Lucia, Suriname and Trinidad, as well as some surveys carried out in areas of Brazil, Colombia and Cuba, have shown a high prevalence (> 10%) of G6PDd. The G6PD A-202A mutation was the variant most broadly distributed across LA and was identified in 81.1% of the deficient individuals surveyed. G6PDd is a frequent phenomenon in LA, although certain Amerindian populations may not be affected, suggesting that PQ could be safely used in these specific populations. Population-wide use of PQ as part of malaria elimination strategies in LA cannot be supported unless a rapid, accurate and field-deployable G6PDd diagnostic test is made available

Engrosamiento de pared vesicular como factor predictivo de choque por dengue en pacientes pediátricos de la sala de infectología del HIMJR Managua, agosto 2005 a agosto 2012

Tesis (MSc. en Ciencias con Mención en Epidemiología)-Universidad Nacional Autónoma de Nicaragua, LeónUNAN-Leó

Body phosphorus mobilization and deposition during lactation in dairy cows

Dairy cow bone phosphorus (P) mobilization and deposition and their influence on P requirements were studied over the lactation cycle. Thirty Holsteins received a common diet during the dry period and one of the following three dietary treatments that varied in P percentage during the subsequent lactation (44 weeks): (i) 0.36 throughout (constant P, 0.36- 0.36-0.36), (ii) 0.36 for 30 weeks then 0.29 for 14 weeks (P changed once, 0.36-0.36-0.29), and (iii) 0.43 for 10 weeks, 0.36 for 20 weeks, and 0.29 for 14 weeks (P changed twice, 0.43-0.36-0.29). Six P balance studies were conducted during the experiment, including one during the dry period and five along lactation, based on P intake, faecal P, urinary P and milk P, when appropriate. Blood samples were taken during balance to analyse bone formation (osteocalcin) and resorption (pyridinoline) marker concentrations and rib biopsies performed to determine bone P content. Phosphorus balance was negative during weeks )4 to )1 relative to lactation for all groups and remained negative for cows fed 0.36% P during weeks 1–5, but showed a positive value for cows that received 0.43% P. The balance was close to zero for all groups at weeks 19–23 and showed a clear retention during weeks 38–42; by the end of lactation, cows re-stored most of the P mobilized earlier. The pattern in P balance was consistent with changes in blood bone metabolism marker concentrations, rib bone P content, and faecal and urinary P concentrations over the experiment, indicating that cows, irrespective of the dietary P treatments received, mobilized P from bone during the late dry period when fed a low-Ca diet and early lactation, and re-stored P in late lactation. This dynamic of P metabolism can have important implications for dietary P requirements and ration formulations.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Agroalimentarias::Estación Experimental de Ganado Lechero Alfredo Volio Mata (EEAVM

Evaluation of the diagnostic utility of the traditional and revised WHO dengue case definitions.

Dengue, a mosquito-borne viral illness, is a major public health problem worldwide, and its incidence continues to increase. In 2009, the World Health Organization published guidelines that included a revision of the dengue case definition. Compared to the traditional definition, the revised case definition relies more on signs than on symptoms, making it more applicable to young children. We evaluated the diagnostic utility of both case definitions in two studies of pediatric dengue in Managua, Nicaragua. In a community-based cohort study, we included data from 3,407 suspected dengue cases, of which 476 were laboratory-confirmed. In the second study, we collected information from 1,160 participants recruited at the national pediatric reference hospital (723 laboratory-confirmed). In the cohort study, the traditional definition had 89.3% sensitivity and 43.1% specificity, while the revised definition yielded similar sensitivity (86.6%) and higher specificity (55.2%, p<0.001). In the hospital study, the traditional case definition yielded 96.7% sensitivity and 22.0% specificity, whereas the revised case definition had higher sensitivity (99.3%, p<0.001) but lower specificity (8.5%, p<0.001). We then evaluated the performance of two diagnostic models based on the signs/symptoms included in each definition by analyzing the effect of increasing numbers of signs/symptoms on the sensitivity and specificity of case capture. Receiver operating characteristic analysis showed a slightly better performance for the revised model in both studies. Interestingly, despite containing less symptoms that cannot be readily expressed by children aged less than 4 years, the revised definition did not perform better in this age group. Overall, our results indicate that both case definitions have similar capacity to diagnose dengue. Owing to their high sensitivity and low specificity, they should be primarily used for screening purposes. However, in a primary care setting, neither of the case definitions performed well as a screening test in younger children

Impact of DC Voltage Enhancement on Partial Discharges in Medium Voltage Cables—An Empirical Study with Defects at Semicon-Dielectric Interface

A scientific consensus is emerging on the benefits of direct current (DC) distribution in medium voltage (MV) power systems of ships and cities. At least 50% space savings and increased power transfer capacity are estimated with enhanced voltage DC operation of electric cables. The goal of this research is to contribute to developing the empirical knowledge on the insulation performance in order to validate the feasibility of such anticipated gains of DC versus alternating current (AC), and to determine the comparative impact of different operational conditions from a component engineering point of view. The partial discharge (PD) activity in cables is measured under AC and DC conditions as an indicator of insulation performance. Specifically, PDs in defects at the semicon-insulation interface are studied in terms of inception voltage, repetition rate and discharge magnitude. Empirical understanding is drawn for operating voltage and frequency dependence of the discharge behavior in such voids in the range of 10 to 20 kV and 0 to 0.1 Hz, respectively. The change in PD activity with void evolution post temperature-induced ageing process is explored