4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Curvas de absorción-extracción mineral bajo un sistema aeropónico para crisantemo blanco (Dendranthema grandiflorum (Ramat.) Kitam. cv. Atlantis White)

El objetivo de este estudio se centró en la construcción de las curvas de absorción-extracción bajo un sistema aeropónico para D. grandiflorum cv. Atlantis White y así plantear los periodos de máxima y mínima acumulación de nutrientes de las biomasas aérea, radical y total. El ciclo vegetativo de la planta, medido desde el día de trasplante (ddt) al sistema aeropónico y el día de inicio de corte, duró 49 días. Las evaluaciones se realizaron cada semana sobre plantas en competencia absoluta. Para el promedio de la biomasa aérea se tomaron tres repeticiones, para la biomasa radical se tomó una sola muestra. La biomasa total promedio alcanzada fue de 130.9313 g planta-1, de la cual el 72.26% (94.163 g) correspondió a la parte aérea y el 27.74% (36.3183 g) a la radical. A partir de contenidos de nutrientes reportados en los análisis de tejidos y las biomasas se calculan los nutrientes absorbidos-extraídos. En términos generales, se observan dos etapas en la absorción de nutrientes, una primera hasta el día 21 ddt y la segunda desde el día 22 hasta el día 49 ddt. Para los elementos reportados en este estudio (N, P, K, Ca, Mg y S); su acumulación durante la primera etapa no supero el 29%, excepto el S que llegó hasta el 30.19 %. En consecuencia, la mayor cantidad de nutrientes, cerca al 70%, fueron absorbidas en la segunda etapa de desarrollo, coincidente con la fase reproductiva de la planta

A comparison of bryophyte diversity in the Macaronesian Islands: island versus habitat approach

In this paper, we present a comparison of richness patterns and floristic similarity for bryophytes in the five most important altitudinal habitat types in the Macaronesian islands. We evaluate the importance of different factors discussed in the literature in predicting species diversity applying the traditional island approach and within the framework of the new habitat approach, including area, isolation, climatic factors, geological age and human influence. From the analysis of patterns of bryophyte species distribution for selected habitats across islands and archipelagos, we specifically test the hypothesis that (i) floristic similarity is primarily determined by climatic factors, but not by geographical distance due to high dispersal ability in this species group and (ii) bryophyte richness is best predicted by area, but not by geological age of the habitat due to very low endemicity or speciation rate and high colonization rate

Eficiency and tolerance of olanzapina vs risperidona and tipical antipsicotics study of 3 years

Objetivo: evaluar los resultados de salud y los costos relacionados con los antipsicóticos disponibles, con énfasis en la olanzapina, en entornos ambulatorios naturalistas. Métodos: 572 pacientes con esquizofrenia (CIE-10 o DSM-IV) que iniciaron o cambiaron a un antipsicótico oral se inscribieron en bloques de diez: 5 pacientes para olanzapina y 5 para otro antipsicótico, según prescripción en ese momento. La eficacia se midió mediante el cambio medio en la puntuación en la Escala de Impresión Clínica Global de Severidad de la Enfermedad (GCI-S). La "respuesta clínica" se definió como la disminución ≥ "2 puntos en el GCI-S si la puntuación inicial era ≥" 4 y la disminución ≥ "1 si la línea base era ≤" 3. "Mínimamente sintomático" se definió como alcanzar una puntuación de 1 o 2 en el GCI-S después de la línea de base. Se registraron los eventos adversos resultantes del tratamiento, junto con el uso de cualquier medicación concomitante y las causas de interrupción de la medicación. Resultados: La Región Andina del SOHO inscribió a 272, 97 y 65 pacientes en monoterapia con olanzapina, antipsicóticos típicos (TA) y risperidona respectivamente. Tanto la olanzapina como la risperidona fueron más eficaces que la AT para mejorar los síntomas generales, positivos y negativos a los 12, 24 y 36 meses, pero solo la olanzapina mostró una diferencia estadísticamente significativa frente a la AT en los síntomas depresivos y cognitivos. Menos pacientes que recibieron olanzapina desarrollaron síntomas extrapiramidales (SEP) y eventos sexuales adversos. Los pacientes tratados con olanzapina demostraron la tasa más baja de discinesia tardía a los 3 años. Más pacientes que recibieron olanzapina aumentaron de peso con una diferencia estadísticamente significativa frente a risperidona y TA. El aumento de peso medio con olanzapina fue de 5 kg y el mayor aumento se registró en los primeros 12 meses de tratamiento. Conclusiones: la olanzapina, pero no la risperidona, fue más efectiva que los típicos mejorando los síntomas depresivos y cognitivos con diferencia estadística. La olanzapina se toleró mejor en términos de EPS, discinesia tardía y deterioro de la función sexual. Se registró una mayor ganancia de peso con olanzapina; sin embargo, la tasa de interrupción debido a la intolerancia fue la más baja. Estos resultados apoyan los mayores beneficios de Atypicals en términos de efectividad y tolerabilidad. © INNN, 2007. Conclusiones: la olanzapina, pero no la risperidona, fue más efectiva que los típicos mejorando los síntomas depresivos y cognitivos con diferencia estadística. La olanzapina se toleró mejor en términos de EPS, discinesia tardía y deterioro de la función sexual. Se registró una mayor ganancia de peso con olanzapina; sin embargo, la tasa de interrupción debido a la intolerancia fue la más baja. Estos resultados apoyan los mayores beneficios de Atypicals en términos de efectividad y tolerabilidad. © INNN, 2007. Conclusiones: la olanzapina, pero no la risperidona, fue más efectiva que los típicos mejorando los síntomas depresivos y cognitivos con diferencia estadística. La olanzapina se toleró mejor en términos de EPS, discinesia tardía y deterioro de la función sexual. Se registró una mayor ganancia de peso con olanzapina; sin embargo, la tasa de interrupción debido a la intolerancia fue la más baja. Estos resultados apoyan los mayores beneficios de Atypicals en términos de efectividad y tolerabilidad.Objective: to evaluate the health results and the costs related to the available antipsychotics, with emphasis on olanzapine, in naturalistic outpatient settings. Methods: 572 patients with schizophrenia (ICD-10 or DSM-IV) who began or changed to an oral, antipsychotic were enrolled in blocks of ten: 5 patients for olanzapine and 5 for another antipsychotic, according to the prescription at that time. The effectiveness was measured by the mean change in score on the Global Clinical Impression of Severity of illness Scale (GCI-S). "Clinical response" was defined as the decrease ≥" 2 points on the GCI-S if the baseline score was ≥" 4 and the decrease ≥" 1 if the baseline was ≤" 3. "Minimally symptomatic" was defined as reaching a score of 1 or 2 on the GCI-S after the baseline. Adverse events resulting from the treatment were recorded, along with the use of any concomitant medication and the causes of discontinuation of the medication. Results: The SOHO Andean Region enrolled 272, 97 and 65 patients in monotherapy with olanzapine, typical antipsychotics (TA) and risperidone respectively. Both olanzapine and risperidone were more effective than the TA in improving the general, positive and negative symptoms at 12, 24, and 36 months, but only olanzapine showed a statistically significant difference vs TA in depressive and cognitive symptoms. Less patients on olanzapine developed extrapyramidal symptoms (EPS) and adverse sexual events. The patients on olanzapine demonstrated the lowest rate of tardive dyskinesia at 3 years. More patients on olanzapine gained weight with a statistically significant difference vs risperidone and TA. The mean weight gain with olanzapine was 5 kg and the greatest increase was recorded in the first 12 months of treatment. Conclusions: olanzapine, but not risperidone, was more effective than typicals improving depressive and cognitive symptoms with statistical difference. Olanzapine was better tolerated in terms of EPS, tardive dyskinesia and sexual function impairment. A greater weight gain was recorded with olanzapine; however, the discontinuation rate due to intolerability was the lowest. These results support the greater benefits of Atypicals in terms of effectiveness and tolerability