Determinar la viabilidad para la creación de una empresa productora y comercializadora de pulpa de fruta derivada de la maracuyá en el municipio de la Plata, Huila

Con este proyecto se busca identificar la necesidad que se tiene en el aprovechar un producto tan importante y nutritivo como lo es la maracuyá, en el municipio de la Plata-Huila. En la búsqueda de estrategias para dar un buen manejo y consumo de la misma se pensó en la elaboración de la pulpa de fruta de maracuyá el cual permitirá aprovechar al máximo y aumentar la participación de los campesinos en el mercado. La producción de la pulpa de fruta de maracuyá permitirá aprovechar al máximo la fruta evitando la pérdida masiva de todos sus componentes. De la misma manera busca el beneficio para el municipio tanto en los consumidores, como en los productores incrementando el desarrollo económico de la ciudad. El proyecto trata temas importantes como: Económicos, sociales, geográficos, tecnológicos, etc. Enfoca el correcto aprovechamiento de la fruta, en la búsqueda de la comercialización sostenible, a través de estudios de mercado realizados, conocimientos de clientes, análisis y automatización de procesos para la creación de empleo y el mejoramiento de la calidad de vida del municipio.Con este proyecto se busca identificar la necesidad que se tiene en el aprovechar un producto tan importante y nutritivo como lo es la maracuyá, en el municipio de la Plata-Huila. En la búsqueda de estrategias para dar un buen manejo y consumo de la misma se pensó en la elaboración de la pulpa de fruta de maracuyá el cual permitirá aprovechar al máximo y aumentar la participación de los campesinos en el mercado. La producción de la pulpa de fruta de maracuyá permitirá aprovechar al máximo la fruta evitando la pérdida masiva de todos sus componentes. De la misma manera busca el beneficio para el municipio tanto en los consumidores, como en los productores incrementando el desarrollo económico de la ciudad. El proyecto trata temas importantes como: Económicos, sociales, geográficos, tecnológicos, etc. Enfoca el correcto aprovechamiento de la fruta, en la búsqueda de la comercialización sostenible, a través de estudios de mercado realizados, conocimientos de clientes, análisis y automatización de procesos para la creación de empleo y el mejoramiento de la calidad de vida del municipio

Eda en menores de cinco años. Promocion y prevencion

El tema escogido para la realización del trabajo de campo es acerca de la Enfermedad Diarreica Aguda en niños menores de cinco años promoción y prevención. El motivo por el cual se escogió el tema es que en los diferentes municipios a los cuales pertenecemos el grupo colaborativo, se ha presentado como un problema de salud pública contenido en el plan territorial de salud de cada municipio. Con este trabajo esperamos informar y concientizar a muchas personas sobre crear estilos de vida saludables y reducir así la diarrea en niños menores de cinco años, que entiendan que con un hábito tan sencillo como lavarse las manos antes de comer y después de ir al baño, están protegiendo la salud y la vida de sus hijos.El tema escogido para la realización del trabajo de campo es acerca de la Enfermedad Diarreica Aguda en niños menores de cinco años promoción y prevención. El motivo por el cual se escogió el tema es que en los diferentes municipios a los cuales pertenecemos el grupo colaborativo, se ha presentado como un problema de salud pública contenido en el plan territorial de salud de cada municipio. Con este trabajo esperamos informar y concientizar a muchas personas sobre crear estilos de vida saludables y reducir así la diarrea en niños menores de cinco años, que entiendan que con un hábito tan sencillo como lavarse las manos antes de comer y después de ir al baño, están protegiendo la salud y la vida de sus hijos

El liderazgo transformacional de las directoras de instituciones educativas públicas de educación inicial - Chimbote, 2016

La presente investigación tuvo como propósito determinar las características del liderazgo transformacional de las directoras de las Instituciones Educativas Públicas de Inicial en opinión de las docentes - Chimbote, 2016. La población estuvo constituida por 80 profesoras de Educación Inicial, se trabajó con una muestra de 48 docentes que trabajan en 07 instituciones educativas del nivel de educación inicial, cuyas directoras fueron nombradas por concurso público en el año 2014, convocado por el Ministerio de Educación. Y se optó por una investigación no experimental y con un diseño descriptivo simple. Para la recolección de la información se utilizaron el Cuestionario multifactorial de liderazgo 5x versión corta (MLQ SX) para docentes de B. Bass y B. Avolio (2000). Adaptado por Martínez, Y (2007). Los resultados revelan que, en opinión de las docentes, sus directoras poseen las características del liderazgo transformacional; siendo la característica que ha obtenido mayor puntuación la de Motivación inspiracional con un 81.3%. Podemos indicar que se percibe un liderazgo transformacional en las directoras de las Instituciones Educativas Públicas de Educación Inicial de Chimbote y qué actualmente están gerenciando sus instituciones educativas bajo este estilo de liderazgo.Trabajo de investigació

Meningitis por criptococo y trombosis venosa cerebral en paciente sicklémica

A 47-year-old woman diagnosed with sickle cell anemia and a vaso-occlusive crisis in the brain was admitted with fever, general malaise and headache, with transient episodes of disorientation. In her evolution, there was a motor defect in the right side, dysarthria and convulsive seizures refractory to therapy. The cranial tomographic study revealed a hypodense image in the left parietal lobe in relation with an infarction, and evidence of contrast enhancement in the turns in the affected area due to cortical vein thrombosis. The patient had a torpid evolution, and died with neurological impairment and septic respiratory symptoms. At necropsy, it was concluded the presence of Cryptococcus neoformans meningitis and cerebral venous thrombosis in a sickle cell anemia patient, associated with severe bilateral bacterial bronchopneumonia that lead to her death. Infections in immunocompromised patients, and especially fungal infections, may not be suspected and may not be treated, as occurred with this patient. This fact, and the association with cerebral venous thrombosis, motivated a discussion in the clinicopathological session of the institution. The study of the autopsy is reported, as well as a review of the condition as a way of focusing attention on opportunistic fungal infections. This is another tough battleground for the diagnosis and treatment of patients, in which the main weapon is the proper use of the epidemiological-clinical method in all medical specialties – efforts must be directed that way.Mujer de 47 años de edad con diagnóstico de sicklemia y crisis vaso-oclusiva cerebral que fue ingresada por fiebre, toma del estado general y cefalea, con episodios de desorientación transitoria; en su evolución aparecieron un defecto motor derecho, disartria y episodios convulsivos refractarios a la terapéutica. El estudio tomográfico de cráneo reveló una imagen hipodensa en el lóbulo parietal izquierdo en relación con infarto, así como evidencias de realce de contraste en los giros en el área afectada debido a trombosis de venas corticales. Evolucionó tórpidamente y falleció con deterioro neurológico y cuadro respiratorio séptico. En la necropsia se concluyó: meningitis por Cryptococcus neoformans y trombosis venosa cerebral, asociadas a bronconeumonía bacteriana bilateral severa en paciente sicklémica, todo lo que la conduce a la muerte. Las infecciones en el paciente inmunodeprimido, y en especial las infecciones por hongos, pueden no ser sospechadas ni tratadas, como sucedió en este caso; este hecho, y la asociación con trombosis venosa cerebral, motivaron a discusión en Sesión Clínico-Patológica Institucional. Se presenta el estudio de la autopsia y la revisión de la enfermedad como forma de enfocar la atención en las infecciones micóticas oportunistas, otro duro campo de batalla para el diagnóstico y el tratamiento de los enfermos, cuya arma fundamental es el empleo adecuado del método clínico en todas las especialidades médicas, hacia lo que se deben dirigir los esfuerzos

Twist exome capture allows for lower average sequence coverage in clinical exome sequencing

Background Exome and genome sequencing are the predominant techniques in the diagnosis and research of genetic disorders. Sufficient, uniform and reproducible/consistent sequence coverage is a main determinant for the sensitivity to detect single-nucleotide (SNVs) and copy number variants (CNVs). Here we compared the ability to obtain comprehensive exome coverage for recent exome capture kits and genome sequencing techniques. Results We compared three different widely used enrichment kits (Agilent SureSelect Human All Exon V5, Agilent SureSelect Human All Exon V7 and Twist Bioscience) as well as short-read and long-read WGS. We show that the Twist exome capture significantly improves complete coverage and coverage uniformity across coding regions compared to other exome capture kits. Twist performance is comparable to that of both short- and long-read whole genome sequencing. Additionally, we show that even at a reduced average coverage of 70× there is only minimal loss in sensitivity for SNV and CNV detection. Conclusion We conclude that exome sequencing with Twist represents a significant improvement and could be performed at lower sequence coverage compared to other exome capture techniques

A Solve-RD ClinVar-based reanalysis of 1522 index cases from ERN-ITHACA reveals common pitfalls and misinterpretations in exome sequencing

Purpose Within the Solve-RD project (https://solve-rd.eu/), the European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies aimed to investigate whether a reanalysis of exomes from unsolved cases based on ClinVar annotations could establish additional diagnoses. We present the results of the “ClinVar low-hanging fruit” reanalysis, reasons for the failure of previous analyses, and lessons learned. Methods Data from the first 3576 exomes (1522 probands and 2054 relatives) collected from European Reference Network for Intellectual disability, TeleHealth, Autism and Congenital Anomalies was reanalyzed by the Solve-RD consortium by evaluating for the presence of single-nucleotide variant, and small insertions and deletions already reported as (likely) pathogenic in ClinVar. Variants were filtered according to frequency, genotype, and mode of inheritance and reinterpreted. Results We identified causal variants in 59 cases (3.9%), 50 of them also raised by other approaches and 9 leading to new diagnoses, highlighting interpretation challenges: variants in genes not known to be involved in human disease at the time of the first analysis, misleading genotypes, or variants undetected by local pipelines (variants in off-target regions, low quality filters, low allelic balance, or high frequency). Conclusion The “ClinVar low-hanging fruit” analysis represents an effective, fast, and easy approach to recover causal variants from exome sequencing data, herewith contributing to the reduction of the diagnostic deadlock

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Subcutaneous anti-COVID-19 hyperimmune immunoglobulin for prevention of disease in asymptomatic individuals with SARS-CoV-2 infection: a double-blind, placebo-controlled, randomised clinical trialResearch in context

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN