Inducción fallida al trabajo de parto con uso de prostaglandinas en pacientes con Bishop 3-5 y sus factores asociados en un hospital público II-2 en Piura 2018-2019

OBJETIVO: Determinar los factores asociados a la inducción fallida al trabajo de parto con uso de prostaglandinas en pacientes con BISHOP 3-5 en el Hospital de la Amistad Perú Corea-Santa Rosa II-2 durante los años 2018-2019. MÉTODO: Estudio de tipo observacional, transversal y analítico. A través de historias clínicas se obtuvo información sobre gestantes de 18 años o más que se presentaron para atención en el Hospital de la Amistad Perú Corea-Santa Rosa II-2 y cuyo manejo fue inducción de labor de parto con prostaglandina E1 (misoprostol). RESULTADOS: Se incluyeron 182 gestantes. La prevalencia de inducción fallida del trabajo de parto fue 34.6%. La inducción fallida del trabajo de parto predominó en los pacientes menores de 20 años. La indicación más frecuente fue rotura prematura de membranas. El resultado más frecuente hallado postinducción fue la hiperactividad uterina. Las características clínicas no se asociaron a inducción fallida del trabajo de parto. Los factores que se asociaron significativamente con una inducción fallida fueron la edad materna menor o igual a 20 años (ORa 2.39, IC95% 1.18 a 4.81, p: 0.01), puntaje de BISHOP entre 3 y 4 puntos (ORa 2.08, IC95% 1.09 a 3.96, p: 0.02) y el sexo masculino del neonato (ORa 1.63, IC95% 1.09 a 3.96, p: 0.02). CONCLUSIÓN: Se asociaron a una prevalencia dos veces mayor de inducción fallida de trabajo de parto la edad materna menor o igual a 20 años, el puntaje de BISHOP entre 3 y 4 puntos, y el sexo masculino del neonato.OBJECTIVE: To determine the factors associated with failed induction of labor with the use of prostaglandins in patients with BISHOP 3-5 at Hospital de la Amistad Perú Corea-Santa Rosa II-2 during the years 2018-2019. METHOD: Observational, cross-sectional and analytical study. Through medical records, information was obtained on pregnant women aged 18 years or older who presented for care at the Peru Korea-Santa Rosa II-2 Friendship Hospital and whose management was induction of labor with prostaglandin E1 (misoprostol). RESULTS: A total of 182 pregnant women were included. The prevalence of failed induction of labour was 34.6%. Failed induction of labour was prevalent in people younger than 20 years. The most frequent indication was premature rupture of membranes. The most frequent outcome found post-induction was uterine hyperactivity. Clinical features were not associated with failed induction of labour. The factors that were significantly associated with failed induction were maternal age less than or equal to 20 years (aOR 2.39, 95% CI 1.18 to 4.81, p: 0.01), BISHOP score between 3 and 4 points (aOR 2.08, 95% CI 1.09 to 3.96, p: 0.02) and male sex of the neonate (aOR 1.63, 95% CI 1.09 to 3.96, p: 0.02). CONCLUSION: A two-fold higher prevalence of failed induction of labour was associated with maternal age less than or equal to 20 years, a BISHOP score between 3 and 4 points, and the male sex of the neonate.Tesi

Pedagogía del asombro y de la promesa en Instituciones Educativas Católicas

Esta investigación tuvo como objetivo analizar si la Pedagogía del Asombro y de la Promesa promueve una cultura del encuentro. Para ello, se profundizó en la propuesta de Bobadilla (2019) en torno a una pedagogía del asombro y una pedagogía de la promesa para hacer visible la cultura del encuentro y así enfrentar los desafíos de la cultura del divertimento. Es así que, haciendo uso de la técnica de análisis documental —a través de estudios y reflexiones de diversos filósofos y educadores— se corroboró la pertinencia del asombro y de la promesa como capacidades humanas necesarias de ser recuperadas para dar hondura y sostenibilidad a la vida de las personas y así generar encuentro. Por ello, con los resultados de esta investigación y partiendo de la antropología cristiana, se desarrolló una propuesta titulada Pedagogía del Asombro y de la Promesa con el fin de promover una cultura del encuentro a través de la formación del ser del estudiante. Con este propósito, la mencionada propuesta pedagógica busca perfeccionar, desde el asombro y la promesa, las propiedades constitutivas de la persona -intimidad, libertad, diálogo-relacionalidad y dar- a través del desarrollo de capacidades que consideran la realidad, la contemplación y el tiempo como aspectos relevantes que hay que tener en cuenta en su proceso. Asimismo, esta propuesta pedagógica se plantea para ser aplicada de manera transversal, a manera de una educación invisible y/o en los planes de tutoría de instituciones educativas católicas.Tabla de Contenido Índice de tablas .................................................................................................................... 7 Resumen ............................................................................................................................... 8 Abstract……...……………………………………………………………………………..9 Introducción………………………………………………………………………………10 Capítulo I: Planteamiento del Problema ......................................................................... 13 1.1 Descripción del Problema......................................................................................... 13 1.2 Formulación del Problema ........................................................................................ 18 1.2.1 Problema General ........................................................................................... 18 1.2.2 Problemas Específicos.................................................................................... 18 1.3 Objetivos................................................................................................................... 18 1.3.1 Objetivo General............................................................................................. 18 1.3.2 Objetivos Específicos ..................................................................................... 18 1.4 Justificación de la Investigación ............................................................................... 19 Capítulo II: Marco Teórico .............................................................................................. 20 2.1 Antecedentes de la Investigación.............................................................................. 20 2.1.1 Antecedentes Internacionales ......................................................................... 21 2.1.2 Antecedentes Nacionales................................................................................ 27 2.2 Bases Teóricas........................................................................................................... 28 2.2.1 Cuestiones Previas.......................................................................................... 28 2.2.2 Cultura Contemporánea y Educación ............................................................. 31 2.2.3 El Asombro, Medio para Descubrir el Ser en la Realidad.............................. 46 2.2.4 La Promesa, Medio para permanecer en el ser y dar Sostenibilidad a la Narrativa Humana........................................................................................................................ 55 2.2.5 Educación Personalizada: Antropología y Principios Educativos.................. 70 2.3 Definición de Términos Base……..………..………………………………………79 Capítulo III: Metodología ................................................................................................. 81 3.1 Enfoque la Investigación .......................................................................................... 81 3.2 Tipo de Investigación................................................................................................ 81 3.3 Nivel de Investigación .............................................................................................. 81 3.4 Diseño de la Investigación ........................................................................................ 82 3.5 Población y Muestra ................................................................................................. 82 3.6 Técnica ...................................................................................................................... 82 Capítulo IV: Resultados De la Investigación……………………………………………84 4.1 Pedagogía del Asombro y de la Promesa para Promover una Cultura del Encuentro 86 4.1.1 Pedagogía del Asombro .................................................................................. 85 4.1.2 Pedagogía de la Promesa ................................................................................ 87 4.1.3 Síntesis: Pedagogía del Asombro y de la Promesa ......................................... 88 4.2 Propiedades Constitutivas de la Persona................................................................... 92 4.2.1 La Intimidad y el Mundo Interior ................................................................... 94 4.2.2 La Libertad...................................................................................................... 97 4.2.3 El Diálogo - la Relacionalidad........................................................................ 98 4.2.4 El Dar............................................................................................................ 100 4.3 Capacidades que Desarrolla el Estudiante desde el Asombro y la Promesa........... 101 4.3.1 Capacidades para Perfeccionar la Intimidad................................................. 103 4.3.2 Capacidad para Perfeccionar la Libertad...................................................... 113 4.3.3 Capacidad para Perfeccionar el Diálogo - la Relacionalidad ....................... 114 4.3.4 Capacidad para Perfeccionar la Propiedad Constitutiva de Dar................... 116 4.4 Dimensiones de la Pedagogía del Asombro y la Promesa ...................................... 117 4.4.1 La Realidad................................................................................................... 117 4.4.2 La Contemplación......................................................................................... 118 4.4.3 El Tiempo ..................................................................................................... 121 4.5 Álgunos Ámbitos Sugeridos para el Desarrollo de la Pedagogía del Asombro y la Promesa ......................................................................................................................... 124 4.5.1 La Literatura y el Cine.................................................................................. 126 4.5.2 La Música ..................................................................................................... 128 4.5.3 El Arte........................................................................................................... 129 4.5.4 Los Paseos..................................................................................................... 130 4.6 Diálogo de la Pedagogía del Asombro y la Promesa con el Currículo de la Educación Básica Regular del Perú................................................................................................. 131 Conclusiones..................................................................................................................... 135 Recomendaciones............................................................................................................. 138 Referencias....................................................................................................................... 139 Anexo ................................................................................................................................ 15

Propuesta de estrategias y medidas en España y Portugal para la prevención y tratamiento no invasivo de la caries en la clínica dental

Introducción: En 2010 se creó la "Alianza por un Futuro Libre de Caries (Alliance for a Cavity-Free Future -ACFF-) con objetivos para el tratamiento no invasivo y prevención de la caries dental a nivel mundial. Para España y Portugal se creó en 2013 el I Consejo Asesor Ibérico de Caries (I Iberian Caries Advisory Board -ICAB-), que decidió desarrollar una Técnica de Grupo Nominal (TGN) con el objetivo de identificar/establecer las medidas/estrategias prioritarias para conseguir los objetivos tanto del ICAB como de la ACFF con acciones en clínicas dentales. Material y métodos: Se realizó una TGN en Madrid en octubre de 2013, con ocho expertos. La pregunta fue "¿Qué medidas efectivas propondría como experto para fomentar la prevención de la caries dental en las clínicas dentales en España y Portugal?". Las fases fueron: 1. Generación de ideas, 2. Su enunciado y explicación, 3. Discusión y fusión de ideas por consenso, 4. Priorización por votación secreta entre las diez ideas colapsadas resultantes. Resultados: Las tres ideas más votadas fueron: 1. Formación a Profesionales, 2. Motivación del profesional y 3. Elaboración de una Guía de Práctica Clínica. Conclusiones: Existe consenso al proponer estrategias/medidas comunes en España y Portugal para mejorar la implementación de la prevención de la caries en las clínicas dentales

The contributions of transboundary networks to environmental governance: The legacy of the MAP initiative

Because many environmental threats span national boundaries, transboundary networks have emerged as a form of multi-stakeholder platform to support environmental governance (EG). There are transboundary networks in various ecologically important regions of the world such as the Amazon. However, there remains a need for systematic analyses to adequately evaluate the contributions of transboundary networks to EG. This paper takes up the case of the “MAP Initiative”, a transboundary network in the tri-national frontier of the southwestern Amazon that sought to support EG. We examine three key questions: 1) how do transboundary networks motivate participants to engage in collaboration across boundaries for EG, 2) how do transboundary networks evolve structurally as well as strategically to increase their impact on EG, and 3) can transboundary networks generate outcomes beyond information sharing for EG? The analysis draws on historical documents, participant observation, and key informant interviews about the MAP Initiative. The findings confirm that transboundary networks motivate cross-border exchanges in multiple ways, they evolve structurally in multiple ways that increase their capacity, and that evolution supports multiple forms of activities and outcomes that support EG. We conclude with a discussion of the contributions and challenges of transboundary networks regarding EG

Propuesta de estrategias y medidas en España y Portugal para la prevención y tratamiento no invasivo de la caries en la clínica dental

Introducción: En 2010 se creó la "Alianza por un Futuro Libre de Caries (Alliance for a Cavity-Free Future -ACFF-) con objetivos para el tratamiento no invasivo y prevención de la caries dental a nivel mundial. Para España y Portugal se creó en 2013 el I Consejo Asesor Ibérico de Caries (I Iberian Caries Advisory Board -ICAB-), que decidió desarrollar una Técnica de Grupo Nominal (TGN) con el objetivo de identificar/establecer las medidas/estrategias prioritarias para conseguir los objetivos tanto del ICAB como de la ACFF con acciones en clínicas dentales. Material y métodos: Se realizó una TGN en Madrid en octubre de 2013, con ocho expertos. La pregunta fue "¿Qué medidas efectivas propondría como experto para fomentar la prevención de la caries dental en las clínicas dentales en España y Portugal?". Las fases fueron: 1. Generación de ideas, 2. Su enunciado y explicación, 3. Discusión y fusión de ideas por consenso, 4. Priorización por votación secreta entre las diez ideas colapsadas resultantes. Resultados: Las tres ideas más votadas fueron: 1. Formación a Profesionales, 2. Motivación del profesional y 3. Elaboración de una Guía de Práctica Clínica. Conclusiones: Existe consenso al proponer estrategias/medidas comunes en España y Portugal para mejorar la implementación de la prevención de la caries en las clínicas dentales

Naturally occurring SARS-CoV-2 gene deletions close to the spike S1/S2 cleavage site in the viral quasispecies of COVID19 patients

Altres ajuts: This study was partially supported by the Direcció General de Recerca i Innovació en Salut (DGRIS) Catalan Health Ministry Generalitat de Catalunya through Vall d'Hebron Institut de Recerca (VHIR) and Centro para el Desarrollo Tecnológico Industrial (CDTI) from the Spanish Ministry of Economy and Business, grant number IDI-20200297.The SARS-CoV-2 spike (S) protein, the viral mediator for binding and entry into the host cell, has sparked great interest as a target for vaccine development and treatments with neutralizing antibodies. Initial data suggest that the virus has low mutation rates, but its large genome could facilitate recombination, insertions, and deletions, as has been described in other coronaviruses. Here, we deep-sequenced the complete SARS-CoV-2 S gene from 18 patients (10 with mild and 8 with severe COVID-19), and found that the virus accumulates deletions upstream and very close to the S1/S2 cleavage site (PRRAR/S), generating a frameshift with appearance of a stop codon. These deletions were found in a small percentage of the viral quasispecies (2.2%) in samples from all the mild and only half the severe COVID-19 patients. Our results suggest that the virus may generate free S1 protein released to the circulation. We suggest that natural selection has favoured a "Don't burn down the house" strategy, in which free S1 protein may compete with viral particles for the ACE2 receptor, thus reducing the severity of the infection and tissue damage without losing transmission capability

Survival of lichens and bacteria exposed to outer space conditions - Results of the Lithopanspermia experiments

n the space experiments Lithopanspermia, experimental support was provided to the likelihood of the lithopanspermia concept that considers a viable transport of microorganisms between the terrestrial planets by means of meteorites. The rock colonising lichens Rhizocarpon geographicum and Xanthoria elegans, the vagrant lichen Aspicilia fruticulosa, and endolithic and endoevaporitic communities of cyanobacteria and bacteria with their natural rock substrate were exposed to space for 10 days onboard the Biopan facility of the European Space Agency (ESA). Biopan was closed during launch and re-entry. In addition, in the Stone facility, one sample of R. geographicum on its natural granitic substrate was attached at the outer surface of the re-entry capsule close to the stagnation point, only protected by a thin cover of glass textolite. Post-flight analysis, which included determination of the photosynthetic activity, LIVE/DEAD staining, and germination capacity of the ascospores, demonstrated that all three lichen were quite resistant to outer space conditions, which include the full spectrum of solar extraterrestrial electromagnetic radiation or selected wavelength ranges. This high resistance of the lichens to space appears to be due to their symbiotic nature and protection by their upper pigmented layer, the cortex. In contrast, the rock- or halite-inhabiting bacteria were severely damaged by the same exposure. After atmospheric re-entry, the granite of the Stone sample was transformed into a glassy, nearly homogenous material, with several friction striae. None of the lichen cells survived this re-entry process. The data suggest that lichens are suitable candidates for testing the concept of lithopanspermia, because they are extremely resistant to the harsh environment of outer space. The more critical event is the atmospheric re-entry after being captured by a planet. Experiments simulating the re-entry process of a microbe-carrying meteoroid did not show any survivors

Conservation and variability of hepatitis B core at different chronic hepatitis stages

Since it is currently not possible to eradicate hepatitis B virus (HBV) infection with existing treatments, research continues to uncover new therapeutic strategies. HBV core protein, encoded by the HBV core gene (HBC), intervenes in both structural and functional processes, and is a key protein in the HBV life cycle. For this reason, both the protein and the gene could be valuable targets for new therapeutic and diagnostic strategies. Moreover, alterations in the protein sequence could serve as potential markers of disease progression. To detect, by next-generation sequencing, HBC hyper-conserved regions that could potentially be prognostic factors and targets for new therapies. Thirty-eight of 45 patients with chronic HBV initially selected were included and grouped according to liver disease stage [chronic hepatitis B infection without liver damage (CHB, n = 16), liver cirrhosis (LC, n = 5), and hepatocellular carcinoma (HCC, n = 17)]. HBV DNA was extracted from patients' plasma. A region between nucleotide (nt) 1863 and 2483, which includes HBC, was amplified and analyzed by next-generation sequencing (Illumina MiSeq platform). Sequences were genotyped by distance-based discriminant analysis. General and intergroup nt and amino acid (aa) conservation was determined by sliding window analysis. The presence of nt insertion and deletions and/or aa substitutions in the different groups was determined by aligning the sequences with genotype-specific consensus sequences. Three nt (nt 1900-1929, 2249-2284, 2364-2398) and 2 aa (aa 117-120, 159-167) hyper-conserved regions were shared by all the clinical groups. All groups showed a similar pattern of conservation, except for five nt regions (nt 1946-1992, 2060-2095, 2145-2175, 2230-2250, 2270-2293) and one aa region (aa 140-160), where CHB and LC, respectively, were less conserved (P < 0.05). Some group-specific conserved regions were also observed at both nt (2306-2334 in CHB and 1935-1976 and 2402-2435 in LC) and aa (between aa 98-103 in CHB and 28-30 and 51-54 in LC) levels. No differences in insertion and deletions frequencies were observed. An aa substitution (P79Q) was observed in the HCC group with a median (interquartile range) frequency of 15.82 (0-78.88) vs 0 (0-0) in the other groups (P < 0.05 vs CHB group). The differentially conserved HBC and HBV core protein regions and the P79Q substitution could be involved in disease progression. The hyper-conserved regions detected could be targets for future therapeutic and diagnostic strategies

One and Two-Step In Vitro-In Vivo Correlations Based on USP IV Dynamic Dissolution Applied to Four Sodium Montelukast Products

Montelukast is a weak acid drug characterized by its low solubility in the range of pH 1.2 to 4.5, which may lead to dissolution-limited absorption. The aim of this paper is to develop an in vivo predictive dissolution method for montelukast and to check its performance by establishing a level-A in vitro-in vivo correlation (IVIVC). During the development of a generic film-coated tablet formulation, two clinical trials were done with three different experimental formulations to achieve a similar formulation to the reference one. A dissolution test procedure with a flow-through cell (USP IV) was used to predict the in vivo absorption behavior. The method proposed is based on a flow rate of 5 mL/min and changes of pH mediums from 1.2 to 4.5 and then to 6.8 with standard pharmacopoeia buffers. In order to improve the dissolution of montelukast, sodium dodecyl sulfate was added to the 4.5 and 6.8 pH mediums. Dissolution profiles in from the new method were used to develop a level-A IVIVC. One-step level-A IVIVC was developed from dissolution profiles and fractions absorbed obtained by the Loo–Riegelman method. Time scaling with Levy’s plot was necessary to achieve a linear IVIVC. One-step differential equation-based IVIVC was also developed with a time-scaling function. The developed method showed similar results to a previously proposed biopredictive method for montelukast, and the added value showed the ability to discriminate among different release rates in vitro, matching the in vivo clinical bioequivalence results