254 research outputs found

    Recent advances in understanding lung function development

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    Recent years have witnessed critical contributions to our understanding of the determinants and long-term implications of lung function development. In this article, we review studies that have contributed to advances in understanding lung function development and its critical importance for lung health into adult life. In particular, we have focused on early life determinants that include genetic factors, perinatal events, environmental exposures, lifestyle, infancy lower respiratory tract infections, and persistent asthma phenotypes. Longitudinal studies have conclusively demonstrated that lung function deficits that are established by school age may track into adult life and increase the risk of adult lung obstructive diseases, such as chronic obstructive pulmonary disease. Furthermore, these contributions have provided initial evidence in support of a direct influence by early life events on an accelerated decline of lung function and an increased susceptibility to its environmental determinants well into adult life. As such, we argue that future health-care programs based on precision medicine approaches that integrate deep phenotyping with tailored medication and advice to patients should also foster optimal lung function growth to be fully effective

    Development of a Global Network for PBL and Engineering Education

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    University Teachers’ Change Readiness to Implement Education for Sustainable Development through Participation in a PBL-Based PD Program

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    This study investigated university teachers' perspectives on their change readiness to implement education for sustainable development (ESD) through their participation in a problem-based learning (PBL) pedagogical development (PD) program. Theoretically, the study connected a systems-thinking approach to change readiness literature and proposed a four-dimensional conceptual framework, including intrapersonal, relational, and environmental dimensions. Q methodology was adopted to collect and analyze data both qualitatively and quantitatively. Four significantly different viewpoints emerged among the 25 participants regarding what they considered most important for their change readiness towards ESD, namely (1) improvement of teaching and learning performance, (2) personal learning and conviction, (3) applying PD learning to practice, and (4) student learning engagement and professional practice. Revealing a complex and interrelated connection between the four dimensions of change readiness, these results also observed university teachers' expression of learning gains and engagement in prospective change. Nevertheless, such change readiness was mainly within their micro teaching practice environment, with little anticipation of commitment to a wider institutional scale of change. Such restrictions on their change readiness were attributed to constrained institutional conditions and supports for long-term improvement. Results of the study suggested that it is essential to facilitate both individual awareness and efforts, as well as institutional readiness for the goal of implementing ESD in higher education (HE). In this regard, both systemic and systematic professional learning activities are recommended

    Continuity and change in the ceramic technology of the northwest of Mendoza province (Argentina)

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    Se presentan los resultados del análisis de un conjunto cerámico cuyos contextos de hallazgo corresponden a sitios emplazados en distintos ambientes altitudinales del noroeste de Mendoza, y cuyo marco cronológico incluye la totalidad del denominado período Medio de la etapa Agroalfarera del Centro Oeste Argentino. Con el objetivo de evaluar cambios y continuidades en la cerámica al interior del período Medio y observar variación entre sitios de tierras altas y bajas, se llevaron a cabo análisis de distintos estados de atributos medibles y observables a nivel macroscópico, considerando su grado de correlación y coocurrencia temporal y espacial. Desde una perspectiva sincrónica, los resultados sugieren escasas y leves variaciones entre tierras altas y bajas vinculadas a requerimientos funcionales de la alfarería. Desde una perspectiva diacrónica, se observaron cambios y continuidades en la mayor parte de los estados de atributos evaluados. Los cambios observados no aparecen como un salto en el registro determinado por la presencia de cerámica alóctona, sino como una tendencia gradual a la incorporación de determinadas elecciones técnicas replicadas a nivel local, que covarían en el tiempo y pueden estar vinculadas a un escenario de cambios en la subsistencia y en las dinámicas poblacionales a nivel local y regional.In this paper, we present the results of the analysis of a ceramic assemblage from sites located in different altitudinal environments of northwestern Mendoza, with a chronological framework that includes all of the so-called Middle period of the Agropottery stage of Central Western Argentina. To assess the changes and continuities of ceramics within the Middle Period in the study area, and to evaluate the variation between highland and lowland sites, we carried out analyses of different states of measurable and observable attributes at the macroscopic level, taking into account their level of temporal and spatial correlation and co-occurrence. From a synchronous perspective, results suggest few and slight variations between highlands and lowlands, linked to functional requirements of pottery. From a diachronic perspective, we observed changes and continuities in most of the evaluated attribute states. The observed changes do not appear as a break in the archaeological record determined by the presence of allochthonous ceramics but rather as a gradual trend towards the incorporation of certain locally replicated technical choices that co-vary over time, and may be linked to a scenario of changes in subsistence and in population dynamics at the local and regional level

    Validez del índice demográfico integral como medidor del desarrollo socioeconómico y el estado de salud

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    Introducción: Uno de los logros más importantes de la ciencia del siglo XX ha sido el avance en la medición de la riqueza comparativa de los países mediante indicadores, se destacan el producto interno bruto y el índice de desarrollo humano. Objetivo: Evaluar la validez del índice demográfico integral en la medición del nivel de desarrollo y estado de salud de una población para establecer un orden jerárquico acorde a estas 2 características. Método: Se realizó un estudio ecológico, se escogió como población a los 191 países que en el año 2019 disponían de información para el cálculo del índice de desarrollo humano; la muestra fue seleccionada por un muestreo simple aleatorio. La información se obtuvo de la página web Datosmacro. Para analizar los datos se emplearon los coeficientes de validez de Hernández- Nieto y V de Aiken, análisis factorial, correlación de Spearman y el coeficiente de Kappa. Resultados: El análisis por ítems reflejó un elevado acuerdo entre los jueces. Existió una alta correlación y elevada concordancia entre el índice demográfico integral y el índice de desarrollo humano. Se identificó una perfecta correlación entre los indicadores evaluados y el grado de desarrollo, con correlaciones iguales a 1 y -1. Conclusión: El índice demográfico integral constituye un indicador válido en la evaluación del envejecimiento, estado de salud y grado de desarrollo entre países, lo que permitió el ordenamiento de las poblaciones acorde a su desarrollo y condición de salud

    Esophageal cooling for protection during left atrial ablation : a systematic review and meta-analysis

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    Thermal damage to the esophagus is a risk from radiofrequency (RF) ablation of the left atrium for the treatment of atrial fibrillation (AF). The most extreme type of thermal injury results in atrio-esophageal fistula (AEF) and a correspondingly high mortality rate. Various strategies for reducing esophageal injury have been developed, including power reduction, esophageal deviation, and esophageal cooling. One method of esophageal cooling involves the direct instillation of cold water or saline into the esophagus during RF ablation. Although this method provides limited heat-extraction capacity, studies of it have suggested potential benefit. We sought to perform a meta-analysis of published studies evaluating the use of esophageal cooling via direct liquid instillation for the reduction of thermal injury during RF ablation. We searched PubMed for studies that used esophageal cooling to protect the esophagus from thermal injury during RF ablation. We then performed a meta-analysis using a random effects model to calculate estimated effect size with 95% confidence intervals, with an outcome of esophageal lesions stratified by severity, as determined by post-procedure endoscopy. A total of 9 studies were identified and reviewed. After excluding preclinical and mathematical model studies, 3 were included in the meta-analysis, totaling 494 patients. Esophageal cooling showed a tendency to shift lesion severity downward, such that total lesions did not show a statistically significant change (OR 0.6, 95% CI 0.15 to 2.38). For high-grade lesions, a significant OR of 0.39 (95% CI 0.17 to 0.89) in favor of esophageal cooling was found, suggesting that esophageal cooling, even with a low-capacity thermal extraction technique, reduces the severity of lesions resulting from RF ablation. Esophageal cooling reduces the severity of the lesions that may result from RF ablation, even when relatively low heat extraction methods are used, such as the direct instillation of small volumes of cold liquid. Further investigation of this approach is warranted, particularly with higher heat extraction capacity techniques

    Oral Health Care and Multidisciplinary Knowledge at the Volunteering Work in Peru: an Experience Report.

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    People in lower-income societies are facing significant challenges in accessing primary oral health care during their entire lives. Nongovernmental organizations (NGOs) have facilitated the provision of dental services by outreach program volunteers to low-and middle-income countries. Volunteering programs worldwide create a positive new experience between the students and professionals who are able, available, and with the initiative to help others, their objective primarily is to give some relief to those involved in the approximately more than 4 billion people worldwide who have a small or no access to basic dental care. Peru is one of the places in Latin America that needs attention when it comes to oral health care. The highest level of caries disease was biostatistically found in Cuzco. A lack of information regarding oral hygiene could explain this high prevalence of caries in Peru, concluding that the cities around the country of Peru need volunteering intervention. This study is classified as an experience report and a description of a dental volunteer program event. The proscript author has experienced an entire volunteering work in dentistry as an academic dental medicine student. All the activities developed were localized in the city of Cusco in the center of public health named Centro de Salud Clas Wanchaq, promoting oral health actions daily and being able to put into practice the techniques learned before in Brazil. Conclusively, in terms that express the ethical considerations in community oral health, it is necessary to discuss an overview of community oral health from an ethical perspective, including the importance of equity, human rights, and social justice in providing oral health care.People in lower-income societies are facing significant challenges in accessing primary oral health care during their entire lives. Nongovernmental organizations (NGOs) have facilitated the provision of dental services by outreach program volunteers to low-and middle-income countries. Volunteering programs worldwide create a positive new experience between the students and professionals who are able, available, and with the initiative to help others, their objective primarily is to give some relief to those involved in the approximately more than 4 billion people worldwide who have a small or no access to basic dental care. Peru is one of the places in Latin America that needs attention when it comes to oral health care. The highest level of caries disease was biostatistically found in Cuzco. A lack of information regarding oral hygiene could explain this high prevalence of caries in Peru, concluding that the cities around the country of Peru need volunteering intervention. This study is classified as an experience report and a description of a dental volunteer program event. The proscript author has experienced an entire volunteering work in dentistry as an academic dental medicine student. All the activities developed were localized in the city of Cusco in the center of public health named Centro de Salud Clas Wanchaq, promoting oral health actions daily and being able to put into practice the techniques learned before in Brazil. Conclusively, in terms that express the ethical considerations in community oral health, it is necessary to discuss an overview of community oral health from an ethical perspective, including the importance of equity, human rights, and social justice in providing oral health care

    Efectos del cambio climático sobre estados tempranos de Quercus ariifolia (Fagaceae), un encino endémico de bosques estacionalmente secos de México

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    Background and Aims: Tree recruitment in seasonally dry forests occurs during the rainy season. However, higher temperatures and reduced rainfalls are expected in these ecosystems because of climate change. These changes could induce drought conditions during the rainy season and affect tree recruitment. Plants subjected to thermal or water stress often display morphological and physiological shifts addressed to prioritize their survival. If recently emerged tree seedlings display these responses, this could improve their development during the rainy season and increase their survival chances. Our aim was to test whether recently emerged oak seedlings display these responses.Methods: We performed a field experiment with Quercus ariifolia, an oak species endemic to seasonally dry forests of central Mexico. At the beginning of the rainy season (September 2016), we sowed acorns of this species in control plots under the current climate and plots in which climate change was simulated by increasing temperature and reducing rainfall (CCS plots). Seedling emergence and survival were monitored every seven days during the rainy season (until January 2017). At the end of the experiment, we measured several functional traits on surviving seedlings and compared them between controls and CCS plots.Key results: Higher temperature and lower rainfall generated water shortage conditions in CCS plots. This did not affect emergence of seedlings but reduced their survival. Seedlings that survived in CCS plots displayed shifts in their functional traits, which matched with those of plants subjected to thermal and water stress.Conclusions: Our results suggest that climate change can increase the extinction risk of Q. ariifolia in seasonally dry forest of Mexico by reducing the survival of its offspring. Nevertheless, the results also suggest that seedlings developed under climate change conditions can display functional shifts that could confer them tolerance to increased drought.Antecedentes y Objetivos: El reclutamiento de árboles en bosques estacionalmente secos ocurre en la temporada de lluvias. Sin embargo, en estos ecosistemas se esperan mayores temperaturas y menores precipitaciones debido al cambio climático. Estos cambios pueden inducir condiciones de sequía durante la temporada de lluvias y afectar el reclutamiento. Las plantas sometidas a estrés térmico e hídrico usualmente muestran cambios morfológicos y fisiológicos dirigidos a priorizar su supervivencia. Si plántulas recientemente emergidas muestran estas respuestas, esto pudiera mejorar su desarrollo durante la temporada de lluvias y aumentar sus posibilidades de supervivencia. Nuestro objetivo fue establecer si plántulas de encino recién emergidas muestran estas respuestas.Métodos: Realizamos un experimento de campo con Quercus ariifolia, un encino endémico de bosques estacionalmente secos del centro de México. Al comienzo de la temporada de lluvias (septiembre 2016) sembramos bellotas de esta especie en parcelas control bajo el clima actual, y parcelas donde aumentamos la temperatura y redujimos la precipitación (parcelas CCS). La emergencia y la supervivencia de plántulas se registró cada siete días durante la temporada de lluvias (hasta enero 2017). Al final del experimento, medimos varios rasgos funcionales en las plántulas sobrevivientes y los comparamos entre controles y parcelas CCS.Resultados clave: La mayor temperatura y la menor precipitación generaron condiciones de sequía en las parcelas CCS. Esto no afectó la emergencia de plántulas, pero redujo su supervivencia. Las plántulas sobrevivientes en las parcelas CCS mostraron cambios en sus rasgos funcionales, que coincidían con los observados en plantas sometidas a estrés térmico y/o hídrico.Conclusiones: Nuestros resultados sugieren que el cambio climático puede aumentar el riesgo de extinción de Q. ariifolia en bosques estacionalmente secos de México al reducir la supervivencia de plántulas. Sin embargo, los resultados también sugieren que las plántulas desarrolladas en condiciones de cambio climático pueden mostrar alteraciones funcionales que pudieran conferirles tolerancia al aumento de la sequía
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