Thin-layer agar for detection of resistance to rifampicin, ofloxacin and kanamycin in Mycobacterium tuberculosis isolates

BACKGROUND: In low-income countries there is a great need for economical methods for testing the susceptibility of Mycobacterium tuberculosis to antibiotics. OBJECTIVE: To evaluate the thin-layer agar (TLA) for rapid detection of resistance to rifampicin (RMP), ofloxacin (OFX) and kanamycin (KM) in M. tuberculosis clinical isolates and to determine the sensitivity, specificity and time to positivity compared to the gold standard method. METHODS: One hundred and forty-seven clinical isolates of M. tuberculosis were studied. For the TLA method, a quadrant Petri plate containing 7H11 agar with RMP, OFX and KM was used. Results were compared to the Bactec MGIT960 for RMP and the proportion method for OFX and KM. RESULTS: The sensitivity and specificity for RMP and OFX were 100% and for KM they were 100% and 98.7%, respectively. The use of a TLA quadrant plate enables the rapid detection of resistance to the three anti-tuberculosis drugs RMP, OFX and KM in a median of 10 days. CONCLUSION: TLA was an accurate method for the detection of resistance in the three drugs studied. This faster method is simple to perform, providing an alternative method when more sophisticated techniques are not available in low-resource settings

Arbitrage-Free Bond Pricing with Dynamic Macroeconomic Models

We examine the relationship between monetary-policy-induced changes in short interest rates and yields on long-maturity default-free bonds. The volatility of the long end of the term structure and its relationship with monetary policy are puzzling from the perspective of simple structural macroeconomic models. We explore whether richer models of risk premiums, specifically stochastic volatility models combined with Epstein-Zin recursive utility, can account for such patterns. We study the properties of the yield curve when inflation is an exogenous process and compare this to the yield curve when inflation is endogenous and determined through an interest-rate/Taylor rule. When inflation is exogenous, it is difficult to match the shape of the historical average yield curve. Capturing its upward slope is especially difficult as the nominal pricing kernel with exogenous inflation does not exhibit any negative autocorrelation - a necessary condition for an upward sloping yield curve as shown in Backus and Zin (1994). Endogenizing inflation provides a substantially better fit of the historical yield curve as the Taylor rule provides additional flexibility in introducing negative autocorrelation into the nominal pricing kernel. Additionally, endogenous inflation provides for a flatter term structure of yield volatilities which better fits historical bond data.

Toward the Simulation of Flashing Cryogenic Liquids by a Fully Compressible Volume of Fluid Solver

We present a fully compressible single-fluid volume of fluid (VOF) solver with phase change for high-speed flows, where the atomization of the liquid can occur either by the aerodynamics or by the effect of the local pressure. The VOF approximation among a non-miscible phase (non-condensable gas) and a mixture of two fluids (liquid and vapor) represents the liquid core of the jet and its atomization. A barotropic model is used in combination with the equation of state (EoS) to link the mixture density to pressure and temperature. The solver is written with the aim to simulate high-pressure injection in gas–liquid systems, where the pressure of the liquid is great enough to cause significant compression of the surrounding gas. Being designed in an C++ object-oriented fashion, the solver is able to support any kind of EoS; the aim is to apply it to the simulation of the injection of liquid propellant in rocket engines. The present work includes the base development; a verification assessment of the code is provided by the solution of a set of numerical experiments to prove the boundedness, convergence and accuracy of the method. Experimental measurements of a cavitating microscopic in-nozzle flow, available in the literature, are finally used for a first validation with phase change

On the drivers of successful crowdfunding: The case of the platform Verkami

This article analyzes the determinants of successful crowdfunding initiatives using a sample of 5,251 projects from the reward-based Spanish platform Verkami. In contrast to most of the literature that has measured success with a dichotomous variable, we approach success with a continuous one, namely the ratio of achievement, which is measured as the obtained resources over the total amount requested by the promoter. We consider a set of potential determinants of success, which are theoretically well-grounded and cover a variety of spheres related to project features. Results suggest that factors related to the signaling theories such as partnership, having previous experience and interaction with backers are positively associated with the achievement ratio, whereas no significant impact is found for the number of rewards. In addition, we find uneven effects for low and high ratios of achievement, identifying the key determinants in different project stages

Homenaje al Dr. Dr. h.c. Claus Roxin en tres actos

El prólogo y la presentación forman parte del Libro-Homenaje por su nombramiento como Doctor Honoris Causa por la Universidad Inca Garcilaso de la Vega. La trayectoria académica de Claus Roxin, su sistemática teleológica de la dogmática del Derecho Penal orientada a los fines de política criminal y especialmente a los fines preventivos de la pena, pero siempre manteniendo la máxima lisztiana de que el Derecho Penal con sus garantías es la barrera infranqueable de la política criminal, y su gigantesca obra en su conjunto, en sus líneas maestras son conocidas, en gran parte también a través de las traducciones de sus obras más importantes al español, que no necesitan presentación ni siquiera glosa alguna

La Constitución multicultural peruana

La dinámica de la globalización ha conllevado procesos de universalización y de homogeneización cultural, es por ello que, tomando como norte el marco constitucional, se procura comprender estas realidades cambiantes a fin de dar un reconocimiento al tema materia de investigación: multiculturalismo complementado con otras categorías tales como pluralismo e interculturalidad. Asimismo, las realidades cambiantes deben ser analizadas en correlación con el nivel de participación de los órganos jurisdiccionales, tales como el Poder Judicial (impartición de justicia) y el Tribunal Constitucional, los que, a través de la interpretación, promoción y reafirmación del valor e importancia de la sociedad multicultural, reafirman los lazos que unen a esta con la pluralidad sociocultural y sociedad globalizada. El Estado constitucional reconoce los derechos fundamentales de todos los miembros de la comunidad estatal, y atiende las particulares exigencias (culturales, religiosas, lingüísticas, nacionales, etc.) que puedan reclamar algunos miembros de la colectividad. Ello en razón de que en la Constitución Política del Perú de 1993, se opta por la tutela constitucional vía reconocimiento de la diversidad cultural de la nación peruana y se apuesta por una integración. Por último, el autor sostiene que lo álgido del Estado constitucional multicultural tiene que ver con la naturaleza de los derechos reclamados por los pueblos indígenas, que en su mayoría son de índole colectiva: a la consulta previa, a la autodeterminación, al ejercicio de justicia propia, a la propiedad comunal, entre otros, haciendo hincapié en que el derecho a la identidad étnica no solo cuenta con protección a nivel constitucional, sino también cuenta con tutela internacional, puntualmente en el Pacto Internacional de Derechos Civiles y Políticos, toda vez que el fenómeno cultural es inherente a todo grupo humano

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Reclamaciones de pacientes en el servicio de emergencia adultos de un hospital de tercer nivel de atención: Patient complaints in the adult emergency department of a tertiary referral hospital

Introduction: The critical condition of the patient who presents to an emergency department creates a need to provide timely, safe and warm care. Failing to meet these expectations causes patient dissatisfaction, reflected by complaints, which are mostly justified and lead to opportunities for improvement and corrective measures. Objective: To analyze complaints presented by patients and their relatives at the Adult Emergency Department of the Edgardo Rebagliati Martins National Hospital. Methods: Nonexperimental, descriptive, cross-sectional study. Our sample was comprised of 109 complaints between May and November 2019. We used a data collection sheet based on the information in the complaints book for health care services. Results: We identified 187 reasons for complaints. Our results show that direct relatives filed 47.7%; 43% involved Internal Medicine consultations. In the dimension “inadequate treatment by healthcare workers,” 13.9% of patients complained about impolite and rude treatment. In the dimension “delay in care”, 12.8% were discontent due to the lack of timely care. In the dimension “user disagreement with care or treatment received,” 10.2% were dissatisfied with the care they were provided. 60.6% of complaints were satisfactorily resolved within the period specified by current regulations. Conclusion: Most complaints were related to the direct care of the patient.Introducción: La condición crítica del paciente que acude a emergencia genera la necesidad de otorgar una atención oportuna, segura y cálida. No cubrir estas expectativas desencadena en la insatisfacción del paciente, reflejada mediante reclamaciones, las cuales en su mayoría resultan justificadas, generando oportunidades de mejora y medidas correctivas. Objetivo: Analizar las reclamaciones presentadas por el paciente y sus familiares en el servicio de emergencia adultos del Hospital Nacional Edgardo Rebagliati Martins. Métodos: Diseño no experimental, descriptivo, de corte transversal. La muestra estuvo conformada por 109 reclamaciones durante el periodo comprendido de mayo a noviembre 2019. Se utilizó una ficha de recolección de datos con la información del Libro de Reclamaciones en Salud. Resultados: Se identificaron 187 motivos de reclamaciones. Los resultados mostraron que 47,7% fueron presentadas por familiares directos y que 43% correspondieron al área de medicina interna. En la dimensión inadecuado trato por parte del personal asistencial, 13,9% de pacientes mostraron disconformidad frente al trato descortés y grosero; en la dimensión demora en la atención, 12,8% manifestaron encontrarse descontentos por la falta de atención oportuna y, en la dimensión desacuerdo del usuario con la atención o tratamiento recibido, 10,2% quedaron insatisfechos con la atención recibida. 60,6% de reclamaciones se resolvieron satisfactoriamente dentro del plazo exigido en la norma. Conclusión: La mayor cantidad de reclamaciones correspondieron al tipo prestacional, asociadas a la atención directa del paciente