Generalized cost-effectiveness analysis of a package of interventions to reduce cardiovascular disease in Buenos Aires, Argentina

<p>Abstract</p> <p>Background</p> <p>Chronic diseases, represented mainly by cardiovascular disease (CVD) and cancer, are increasing in developing countries and account for 53% of chronic diseases in Argentina. There is strong evidence that a reduction of 50% of the deaths due to CVD can be attributed to a reduction in smoking, hypertension and hypercholesterolemia. Generalized cost-effectiveness analysis (GCE) is a methodology designed by WHO to inform decision makers about the extent to which current or new interventions represent an efficient use of resources. We aimed to use GCE analysis to identify the most efficient interventions to decrease CVD.</p> <p>Methods</p> <p>Six individual interventions (treatment of hypertension, hypercholesterolemia, smoking cessation and combined clinical strategies to reduce the 10 year CVD Risk) and two population-based interventions (cooperation between government, consumer associations and bakery chambers to reduce salt in bread, and mass education strategies to reduce hypertension, hypercholesterolemia and obesity) were selected for analysis. Estimates of effectiveness were entered into age and sex specific models to predict their impact in terms of age-weighted and discounted DALYs saved (disability-adjusted life years). To translate the age- and sex-adjusted incidence of CVD events into health changes, we used risk model software developed by WHO (PopMod). Costs of services were measured in Argentine pesos, and discounted at an annual rate of 3%. Different budgetary impact scenarios were explored.</p> <p>Results</p> <p>The average cost-effectiveness ratio in argentine pesos (ARS$) per DALY for the different interventions were: (i) less salt in bread$151; (ii) mass media campaign $547; (iii) combination drug therapy provided to subjects with a 20$3,599, $4,113 and$4,533, respectively; (iv) high blood pressure (HBP) lowering therapy $7,716; (v) tobacco cessation with bupropion$ 33,563; and (iv) high-cholesterol lowering therapy with statins $ 70,994.</p> <p>Conclusion</p> <p>Against a threshold of average per capita income in Argentina, the two selected population-based interventions (lowering salt intake and health education through mass-media campaigns) plus the modified polypill strategy targeting people with a 20% or greater risk were cost-effective. Use of this methodology in developing countries can make resource-allocation decisions less intuitive and more driven by evidence.</p

PARAMETRIC STUDY OF MUSCULO-ARTICULAR STIFFNESS OBTAINED BY FREE VIBRATION TECHNIQUE

The aim of this study was to analyse the effect of several variables on musculo-articular stiffness (MAS) linked to ankle articulation using free vibration techniques. Twenty one university students participated in the present study. The outcomes: 2nd metatarsal head moment arm (R), Achilles tendon moment arm (r), the ratio of both (R/r), force (f), MAS (k) and a unitary MAS (ku). Independent samples t-tests and One-way ANOVA with repeated measures were carried out. Results: Across gender, very significant differences in k values (

Comparación experimental de la tenacidad a fractura transversal de laminados unidireccionales correspondientes al crecimiento longitudinal o transversal de grietas

XI CONGRESO NACIONAL DE MATERIALES COMPUESTOS. Celebrado en Móstoles los días 6, 7 y 8 de julio de 2015El objetivo del trabajo es determinar y comparar, en laminados unidireccionales, las tenacidades a fractura transversal correspondientes a dos direcciones de crecimiento de grieta, paralela (GIcpar) y perpendicular (GIcperp) a las fibras. Con este propósito, se han diseñado y fabricado dos tipos de probetas para el ensayo de flexión a tres y cuatro puntos, con dimensiones iguales pero con distintas orientaciones de fibras con respecto a la grieta inicial. La principal dificultad encontrada durante la fabricación ha sido la generación de grietas. En este artículo se describen las diferentes técnicas implementadas para la generación de las grietas y los problemas encontrados. Los resultados muestran que los valores de la tenacidad para ambas direcciones de propagación son cercanos, detectándose un valor ligeramente más alto cuando la dirección de propagación es paralela a la fibra.Ministerio de Educación FPU 2009/3968Ministerio de Ciencia e Innovación MAT2009-14022Ministerio de Economía y Competitividad MAT2012-37387Fondo Europeo de Desarrollo Regional MAT2012-37387Junta de Andalucía P08- TEP-4051Fondo Social Europeo P08- TEP-405

El proyecto de la dirección de obra: experiencia pedagógica para la enseñanza

La Facultad de Arquitectura y Urbanismo de la Universidad Nacional de La Plata | FAU-UNLP ha implementado el Plan de Estudios VI/2008, e incorpora para obtener el título de arquitecto, dos Asignaturas Electivas Orientadas (AEO). A partir del segundo llamado de propuestas para el Ciclo Lectivo 2018, se presentaron un total de veinticuatro (24), específicamente cinco (5) en el Área Ciencias Básicas, Tecnología, Producción y Gestión, en la cual ha sido seleccionada la asignatura Dirección de Obra (DDO). Como resultado de la oferta académica de la Facultad en AEO, en las inscripciones 2018 y 2019 se verifica que uno de cada tres estudiantes respectivamente (250 inscriptos en 2018 y 324 en 2019), han seleccionado la AEO - DDO. El presente trabajo expone las acciones llevadas a cabo en innovación tecnológica, volcadas a la enseñanza dentro de nuestra casa de estudios y en el marco de la producción de las metodologías y herramientas, orientado al mejoramiento de la gestión de recursos para el hábitat. La asignatura electiva orientada DDO, articula los contenidos académicos del grado y en conjunto con la Práctica Pre Profesional Asistida (PPPA), profundiza el conocimiento, en la producción de las obras de arquitectura y lleva al estudiante a un nuevo estadio de la aplicación práctica en la gestión de los recursos. El enfoque teórico adoptado establece “El proyecto de la DDO”, como el instrumento que nos permite llegar con mejores resultados a los entregables deseados. En tal sentido para lograr los factores de éxito, encontramos las variables reconocidas como triple restricción (alcance, plazo, costo), y en un juego dialéctico ubicamos las condicionantes sustentables (sociales, ambientales, económicas) como pilares de interfase indivisibles de un sistema. Por otra parte exponer los resultados obtenidos en el ciclo lectivo 2018 y transmitir las estrategias pedagógicas de abordaje, desde la visión de la gestión sustentable del proyecto y la dirección de obra. Las metodologías (ejercicios cognitivos sobre pensamiento lateral), herramientas (encuestas a los estudiantes, previo a la presentación de la propuesta pedagógicas, en el transcurso del dictado de la misma y al finalizar la asignatura) y tecnologías (utilización de TIC, Blog Wordpress, Facebook, Instagram, Google forms, entre otras) aplicadas a obras de pequeña/mediana complejidad logran una variedad de respuestas de los estudiantes ante la problemática, que confrontan en sus primeras experiencias en obra. De esta forma logran una nueva construcción del conocimiento en estrategias de gestión sustentable, desde la mirada del estudiante/arquitecto comprometido con el medio, con “énfasis en la formación ética y la responsabilidad social y política que conllevan las acciones profesionales, así como la protección del medio ambiente y el desarrollo sustentable” (Argentina, 2006: s/n).Facultad de Arquitectura y Urbanism

Variability of Physical and Chemical Properties of TLUD Stove Derived Biochars

Biochar is a carbon-rich organic material, obtained by the thermochemical conversion of biomass in an oxygen-limited environment, used as a soil amendment to stimulate soil fertility and improve soil quality. There is a clear need in developing countries for access to low cost, low technology options for biochar production, for example, top-lit updraft (TLUD) stoves, which are popular and spread worldwide. However, TLUD biochars are inevitably very variable in their properties for a variety of reasons. We present laboratory triplicate tests carried out on TLUD biochars obtained from waste pinewood and a Guadua bamboo. Analyzed properties include specific surface area (A-BET), porosity, skeletal density, hydrophobicity, proximal and elemental composition, cation exchange capacity (CEC), relative liming capacity and pH. SEM images of the bamboo and wood biochars are compared. The biochars were mixed with composted human excreta at 5% and 10% biochar content, and available water content (AWC) was analyzed. Operating temperatures in the TLUD were recorded, showing different behaviors among the feedstocks during the process. Differences in operating temperatures during charring of the bamboo samples seem to have led to differences in A-BET, hydrophobicity and CEC, following unprecedented trends. For the mixtures of the biochars with compost, at 5% biochar no significant differences were observed for AWC. However, in the 10% biochar mixtures, bamboo biochar showed an unexpectedly high AWC. Overall, variations of chemical and physical properties between bamboo biochars were greater, while pinewood biochars showed similar properties, consistent with more homogeneous charring temperaturesThis research was funded by Vice-rector of Research and Extension of the Instituto Tecnológico de Costa Rica (TEC), trough the project VIE 1460065 and by the national foundation FITTACORI (Fundación para el Fomento y Promoción de la Investigación y Transferencia de Tecnología Agropecuaria)S

Crecimiento diario en larvas en postflexión y jueveniles de sardina (Sarcina pilchardus walb) del mar de Alborán: influencia del viento

The Albor&aacute;n Sea is a hydrographically complex and variable area in which wind-driven coastal upwelling occurs. Its most abundant small pelagic resource is the sardine (Sardina pilchardus), which is subject to major interannual oscillations. Postflexion stages of sardine larvae were sampled in their main nursery grounds in the north Albor&aacute;n Sea, and sardine juveniles were sampled periodically throughout the recruitment season. Daily growth analysis was used to identify periods favourable for larval survival and to assess the evolution of daily increment widths during the first months of life. The results showed that juveniles born later in the spawning season grew relatively faster than those born earlier. Two main growth phases were observed in juveniles: an initial one in which daily increment widths increased progressively, and a second one in which widths fluctuated, showing a decreasing trend. The beginning of the second phase was almost synchronous among different sub-cohorts, suggesting that it was triggered by environmental factors. The estimated mean daily growth rates during the larval phase were higher in surviving juveniles than in postflexion larvae born in the same month, supporting the “bigger is better” hypothesis in relation to larval survival. The influence of the environmental regime on growth was explored, and the evolution of a growth-related index, derived from otolith increment width variability, was compared with a single environmental descriptor, a “wind index” based on wind stress and direction. This analysis suggested that larval survival and larval and juvenile growth rates showed a positive correlation with NW component winds, associated with upwelling events on the continental shelf and calm sea weather conditions in the inshore nursery grounds. Conversely, Levantine and southern wind periods, which interrupt the upwelling and create rough seas in the inshore bays, lead to a decrease in growth rates in juveniles and low larval survival.El mar de Albor&aacute;n es una zona hidrogr&aacute;ficamente compleja y variable, en la que se producen fen&oacute;menos de afloramiento costero inducidos por vientos. Su recurso m&aacute;s abundante entre los peque&ntilde;os pel&aacute;gicos es la sardina (Sardina pilchardus), que est&aacute; sujeto a importantes fluctuaciones interanuales. Se muestrearon estadios larvarios avanzados (larvas en estadio de postflexi&oacute;n del urostilo), en sus principales &aacute;reas de reclutamiento del norte del mar de Albor&aacute;n. Los juveniles de sardina fueron muestreados peri&oacute;dicamente a lo largo de la temporada de reclutamiento. Estudios de crecimiento diario permitieron identificar periodos de alta supervivencia larvaria, as&iacute; como analizar la evoluci&oacute;n de la anchura de los microincrementos durante los primeros meses de vida, revelando que los juveniles nacidos m&aacute;s tarde en la &eacute;poca de puesta crecieron relativamente m&aacute;s r&aacute;pido que aquellos nacidos antes. Se observaron en los juveniles dos fases de crecimiento principales: una primera en la cual los incrementos diarios eran progresivamente m&aacute;s anchos y una segunda donde las anchuras de los incrementos fluctuaron, mostrando una tendencia negativa. El inicio de la segunda fase fue casi sincr&oacute;nico entre las diferentes sub-cohortes, sugiriendo que fue determinado por factores ambientales. Las tasas de crecimiento diario medias estimadas durante el periodo larvario fueron mayores en los reclutas supervivientes que en las larvas en postflexi&oacute;n nacidas en el mismo mes, dando apoyo a la hip&oacute;tesis de &ldquo;mayor es mejor&rdquo; en relaci&oacute;n con la supervivencia larvaria. La influencia de las condiciones ambientales sobre el crecimiento se estudi&oacute; relacionando la evoluci&oacute;n temporal de un &iacute;ndice de crecimiento basado en la variabilidad de las anchuras de los incrementos diarios con un sencillo descriptor ambiental, un &ldquo;&iacute;ndice de viento&rdquo; calculado teniendo en cuenta tanto la direcci&oacute;n como la intensidad de los mismos en el &aacute;rea. Este an&aacute;lisis indica una relaci&oacute;n positiva tanto de la supervivencia larvaria como de la evoluci&oacute;n de las tasas de crecimiento diarias en larvas y juveniles con periodos de viento de componente norte y oeste, que producen afloramiento en la plataforma continental y condiciones de mar calma en las bah&iacute;as donde tiene lugar la cr&iacute;a. Al contrario, per&iacute;odos de viento de levante y sur, que interrumpen el afloramiento e inducen condiciones de temporal en las zonas de las bah&iacute;as, producen un descenso de las tasas de crecimiento de los juveniles y una menor supervivencia en las larvas

NS3 genomic sequencing and phylogenetic analysis as alternative to a commercially available assay to reliably determine hepatitis C virus subtypes 1a and 1b

Objective: To evaluate the use of hepatitis C virus (HCV) NS3 sequencing as alternative to the comercially available Versant HCV 2.0 reverse hybridization line-probe assay (LiPA 2.0) to determine HCV genotype 1 (HCV-1) subtypes. Patients and methods: A cohort of 104 patients infected by HCV-1 according to LiPA 2.0 was analyzed in a cross-sectional study conducted in patients seen from January 2012 to June 2016 at an outpatient clinic in Buenos Aires, Argentina. Results: The samples were included within well supported subtype clades: 64 with HCV-1b and 39 with HCV-1a infection. Twenty of the HCV-1a infected patientes were included in a supported sub-clade “1” and 19 individuals were among the basal sub-clade “2”. LiPA 2.0 failed to subtype HCV-1 in 20 (19.2%) individuals. Subtype classification determined by NS3 direct sequencing showed that 2/18 (11.1%) of the HCV-1a-infected patients as determined by LiPA 2.0 were in fact infected by HCV-1b. Of the HCV-1b-infected according to LiPA 2.0, 10/66 (15.2%) patients showed HCV-1a infection according to NS3 sequencing. Overall misclassification was 14.3% (κ-index for the concordance with NS3 sequencing = 0.635). One (1%) patient was erroneously genotyped as HCV-1 and was revealed as HCV genotype 4 infection. Conclusions: Genomic sequencing of the HCV NS3 region represents an adequate alternative since it provides reliable genetic information. It even distinguishes between HCV-1a clades related to resistance-associated substitutions to HCV protease inhibitors, it provides reliable genetic information for genotyping/subgenotyping and simultaneously allows to determine the presence of resistance-associated substitutions to currently recommended DAAs.Fil: Neukam, Karin. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentina. Universidad de Sevilla; España. Hospital Universitario de Valme; EspañaFil: Martínez, Alfredo P.. Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”; ArgentinaFil: Culasso, Andrés Carlos Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Ridruejo, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET.; ArgentinaFil: García, Gabriel. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; ArgentinaFil: Di Lello, Federico Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica; Argentin

Hydrogen as an energy vector to optimize the energy exploitation of a self-consumption solar photovoltaic facility in a dwelling house

Solar photovoltaic (PV) plants coupled with storage for domestic self-consumption purposes seem to be a promising technology in the next years, as PV costs have decreased significantly, and national regulations in many countries promote their installation in order to relax the energy requirements of power distribution grids. However, electrochemical storage systems are still unaffordable for many domestic users and, thus, the advantages of self-consumption PV systems are reduced. Thus, in this work the adoption of hydrogen systems as energy vectors between a PV plant and the energy user is proposed. As a preliminary study, in this work the design of a PV and hydrogen-production self-consumption plant for a single dwelling is described. Then, a technical and economic feasibility study conducted by modeling the facility within the Homer Energy Pro energy systems analysis tool is reported. The proposed system will be able to provide back not only electrical energy but also thermal energy through a fuel cell or refined water, covering the fundamental needs of the householders (electricity, heat or cooling and water). Results show that, although the proposed system effectively increases the energy local use of the PV production and reduces significantly the energy injections or demands into/from the power grid, avoiding power grid congestions and increasing the nano-grid resilience, operation and maintenance costs may reduce its economic attractiveness for a single dwelling. Keywords: Hydrogen, Solar photovoltaics, Energy vector, Power storage, Smart grids, Nano-grid

Aprender jugando con el juego de la vaca: extensión en escuelas rurales del partido de Tandil

Partiendo de reconocer que existen distintas problemáticas ambientales en torno a las prácticas ganaderas y que es necesario comenzar a trabajar el tema desde las edades más tempranas, se elaboró el Juego de la Vaca, un juego de mesa que ha ido evolucionando en su propuesta lúdica, pero manteniendo el objetivo fundamental que los alumnos aprendan jugando. Para ello, se lo puso en práctica en 2012, 2014 y 2015, bajo distintos modelos de juego de mesa en 5 escuelas rurales del Partido de Tandil, alcanzando alrededor de 200 estudiantes. Se logró por medio del mismo despertar el interés de alumnos y docentes por la problemática ganadera en relación al cuidado del ambiente, y colaborar en los proceso de enseñanza/aprendizaje.There are different environmental problems related to farming processes which are necessarily to start developing from early learning stages. In this sense, we elaborated a board game called “Cow game”, which has been evolving/improving in its ludic proposal, always keeping the fundamental objective of learning by playing. This proposal has been performed during 2012, 2014 and 2015, with different board game models, in 5 different rural schools of Tandil District, reaching about 200 students. This project allowed children and teachers to get interested in environmental care and farming impacts and also collaborate in the learning/teaching process

E 2 Program: Building a promoting entrepreneurship model based on a student entrepreneur

RESUMEN: El proyecto e2 (estudiante x emprendedor) es un programa de fomento del emprendimiento desde la universidad hasta niveles no universitarios. Pretende fomentar el emprendimiento entre los universitarios mediante la realización de proyectos empresariales simulados en grupos interdisciplinares, con el apoyo de un empresario por grupo. En última instancia se acudirá a los institutos de Cantabria a dar una charla y fomentar la participación de los estudiantes no universitarios en un simulador empresarial. Para su realización, se captarán quince mentores que recibirán una formación de alto nivel en habilidades para el emprendimiento, y, en una segunda fase, se captarán a setenta y cinco estudiantes para conformar quince grupos de seis personas, que serán los que realicen los proyectos empresariales simulados.ABSTRACT: The e2 project (for entrepreneur and student, in Spanish "emprendedor y estudiante") is a program that promotes entrepreneurship from university to non university levels. It aims to foster entrepreneurship among university students by conducting simulated business projects in interdisciplinary groups supported by one employer in each group. Moreover, this experience will come to high schools of Cantabria by conducting talks that will encourage the participation of non-university students into a business simulator. For its realization, in a first phase, fifteen mentors will be selected and will receive advanced training in entrepreneurship skills; and, in a second phase, seventy-five students will be selected to form fifteen groups of six people, who will be performing the simulated business projects organized in the first phase