Arquitectura naval: de la teoría a la práctica

The complexity of projecting and designing a ship requires a work sequence that covers at least three main areas: (1) Concept engineering; (2) Basic engineering; (3) Detail engineering. This paper explains the design transition that exists (or should exist) between concept engineering and the final product, emphasizing the existing contractual relationship with the shipbuilder, especially in the initial definition of the project and the influence on construction aspects.La complejidad del proyecto y diseño de una embarcación obliga a plantear una secuencia de trabajo que abarca al menos tres grandes áreas: (1) Ingeniería de concepto; (2) Ingeniería básica; (3) Ingeniería de detalle. El presente trabajo explica la transición de diseño que existe (o debería existir) entre la ingeniería de concepto y el producto final, poniendo énfasis en la relación contractual existente con el armador, especialmente en la definición inicial del proyecto y la influencia sobre los aspectos constructivos

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Naval Architecture: From Theory to practice

The complexity of projecting and designing a ship requires a work sequence that covers at least three main areas: (1) Concept engineering; (2) Basic engineering; (3) Detail engineering. This paper explains the design transition that exists (or should exist) between concept engineering and the final product, emphasizing the existing contractual relationship with the shipbuilder, especially in the initial definition of the project and the influence on construction aspects.La complejidad del proyecto y diseño de una embarcación obliga a plantear una secuencia de trabajo que abarca al menos tres grandes áreas: (1) Ingeniería de concepto; (2) Ingeniería básica; (3) Ingeniería de detalle. El presente trabajo explica la transición de diseño que existe (o debería existir) entre la ingeniería de concepto y el producto final, poniendo énfasis en la relación contractual existente con el armador, especialmente en la definición inicial del proyecto y la influencia sobre los aspectos constructivos

Chile bajo la Constitución de 1980: de la transición pactada al proceso constituyente de 2021

The article assesses the evolution of democracy in Chile from the transition to democracy into the settlement of the Constitutional Convention in 2021. Combining institutional and sociological approaches, the main argument consists that the 1980 constitution fostered a strong electoral democracy. However, from an institutional point of view, the rigidity of the constitution allowed a model of constitutional reforms based on intra-elite agreements. These conditions affected negatively the responsiveness of the system to the demands from its environment. At the socio territorial arena, multiple conflicts bursted in the southern regions of the country. Both dimensions converged in the 2019 social unrest, movement that led to the present constituent process.El artículo aborda la evolución de la democracia en Chile desde la transición a la democracia hasta la conformación de la Convención Constitucional en 2021. Combinando una perspectiva institucional y sociológica, el argumento principal consiste en que la Constitución de 1980 permitió construir una democracia electoral sólida. No obstante, desde el punto de vista institucional, la rigidez de la Constitución de 1980 fomentó un modelo de reformas basado en acuerdos de élite, volviendo al sistema institucional poco responsivo ante las demandas ciudadanas. Desde la arena socioterritorial, diversos conflictos estallaron, especialmente en el sur del país. Ambas dimensiones convergieron en el estallido social de 2019, estallido que da vida al actual proceso constituyente

Implementacion y aplicacion al Micro Saint

224 p

Alteration in mitochondrial Ca2+ uptake disrupts insulin signaling in hypertrophic cardiomyocytes

© 2014 Gutierrez et al.; licensee BioMed Central Ltd. Background: Cardiac hypertrophy is characterized by alterations in both cardiac bioenergetics and insulin sensitivity. Insulin promotes glucose uptake by cardiomyocytes and its use as a substrate for glycolysis and mitochondrial oxidation in order to maintain the high cardiac energy demands. Insulin stimulates Ca2+ release from the endoplasmic reticulum, however, how this translates to changes in mitochondrial metabolism in either healthy or hypertrophic cardiomyocytes is not fully understood. Results: In the present study we investigated insulin-dependent mitochondrial Ca2+ signaling in normal and norepinephrine or insulin like growth factor-1-induced hypertrophic cardiomyocytes. Using mitochondrion-selective Ca2+-fluorescent probes we showed that insulin increases mitochondrial Ca2+ levels. This signal was inhibited by the pharmacological blockade of either the inositol 1,4,5-triphosphate receptor or the mitochondrial Ca2+ unipor