Bases and foundations of the treatment of peritoneal carcinomatosis: Review article

Peritoneal carcinomatosis refers to a shedding or tumor that spreads to the peritoneal serosa and structures of the abdominal cavity. It is an entity with a poor prognosis. Several conditions can cause this, the most common being colon, rectum, ovary, stomach or appendix cancers, including peritoneal pseudomyxoma, among others. The abdominal cavity invasion is considered a clinical stage IV. For a long time life expectancy of this entity was very short. With the advent of meticulous techniques in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) the prognosis of patients has changed. In some conditions, these procedures are standard treatments. CRS is a very important prognostic factor; leaving a less residual disease in the patient, the evolution will be better. The HIPEC starts immediately after the surgical event. The hyperthermia increases the cytotoxic effect of antineoplastic drugs. Numerous studies have appeared in medical literature wherein the clear improvement in survival of the affected population is demonstrated. It is essential that a multidisciplinary team participates in the decision for the best treatment option and the maximum clinical benefit of the patients

Estudio de la aplicación del mantenimiento predictivo en motores diésel en la provincia de Manabí

The predictive maintenance of internal combustion engines is in continuous development and application worldwide, diesel internal combustion engines, for their operational advantages have a great weight for the world and national economy, so proper maintenance is necessary to ensure their availability, however the state of the application of predictive maintenance techniques in diesel engines is unknown,  for this reason the objective of the work is to present the results of the exploratory study of the  application of the diagnostic instrument to determine the  state of predictive maintenance of diesel internal combustion engines in the province of Manabí,  particularly to know the equipment, techniques and preparation. The research was developed in an integrated way by several methods such as documentary analysis, systemic analysis, analysis and synthesis, unstructured interview and direct observation. To obtain the field information, we started from the design of the diagnostic instrument with questions oriented to three variables, it was applied to the sample of 24 workshops. As a result of the study it was detected that the  automotive service centers present a low or no level of application of predictive maintenance techniques, the human factor of the after-sales centers is professional while the workshops there is a high index of empirical personnel, that the technical and technological level of the sample presents as the most common tool the scanner and lack techniques  as analysis of oil, gases, vibrations and thermography, that the knowledge required for the application of the techniques is below the regional average and through direct observation it was possible to establish that the infrastructure conditions  are  acceptable for its incorporation. Finally, the above allows us to conclude that the state of the application of predictive maintenance techniques in diesel engines in the province of Manabí is unsatisfactory. Keywords: Predictive maintenance, automotive workshops, automotive technification, automotive sector in Manabí, maintenance by condition.El mantenimiento predictivo de motores de combustión interna se encuentra en continuo desarrollo y aplicación a nivel mundial, los motores de combustión interna diésel, por sus ventajas operativas tienen un gran peso para la economía mundial y nacional, por ello es necesario un correcto mantenimiento para garantizar su disponibilidad, sin embargo se desconoce el estado de la aplicación de las técnicas del mantenimiento predictivo en motores diésel, por esta razón el objetivo del trabajo es exponer los resultados del estudio exploratorio de la aplicación del instrumento diagnóstico para determinar el estado del mantenimiento predictivo de motores de combustión interna diésel en la provincia de Manabí, particularmente conocer el equipamiento, técnicas y preparación. La investigación se desarrolló de forma integrada por varios métodos como el análisis documental, el sistémico, el análisis y síntesis, la entrevista no estructurada y la observación directa. Para obtener la información de campo se partió del diseñó del instrumento diagnostico con preguntas orientadas a tres variables, se aplicó a la muestra de 24 talleres. Como resultado del estudio se detectó que los centros de servicio automotriz presentan un bajo o nulo nivel de aplicación de técnicas del mantenimiento predictivo, el factor humano de los centros de posventa es profesional mientras los talleres existe un alto índice de personal empírico, que el nivel técnico y tecnológico de la muestra presenta como herramienta más común el escáner y carecen de técnicas como análisis de aceite, gases, vibraciones y termografía, que los conocimientos requeridos para la aplicación de las técnicas se encuentra por debajo de la media regional y a través de la observación directa se logró establecer que las condiciones de infraestructura son aceptables para su incorporación. Finalmente, lo expuesto permite concluir que el estado de la aplicación de las técnicas del mantenimiento predictivo en motores diésel en la provincia de Manabí es poco satisfactorio. Palabras clave: Mantenimiento predictivo, talleres automotrices, tecnificación automotriz, sector automotriz en Manabí, mantenimiento por condición. Abstract The predictive maintenance of internal combustion engines is in continuous development and application worldwide, diesel internal combustion engines, for their operational advantages have a great weight for the world and national economy, so proper maintenance is necessary to ensure their availability, however the state of the application of predictive maintenance techniques in diesel engines is unknown,  for this reason the objective of the work is to present the results of the exploratory study of the  application of the diagnostic instrument to determine the  state of predictive maintenance of diesel internal combustion engines in the province of Manabí,  particularly to know the equipment, techniques and preparation. The research was developed in an integrated way by several methods such as documentary analysis, systemic analysis, analysis and synthesis, unstructured interview and direct observation. To obtain the field information, we started from the design of the diagnostic instrument with questions oriented to three variables, it was applied to the sample of 24 workshops. As a result of the study it was detected that the  automotive service centers present a low or no level of application of predictive maintenance techniques, the human factor of the after-sales centers is professional while the workshops there is a high index of empirical personnel, that the technical and technological level of the sample presents as the most common tool the scanner and lack techniques  as analysis of oil, gases, vibrations and thermography, that the knowledge required for the application of the techniques is below the regional average and through direct observation it was possible to establish that the infrastructure conditions  are  acceptable for its incorporation. Finally, the above allows us to conclude that the state of the application of predictive maintenance techniques in diesel engines in the province of Manabí is unsatisfactory. Keywords: Predictive maintenance, automotive workshops, automotive technification, automotive sector in Manabí, maintenance by condition. Información del manuscrito:Fecha de recepción: 04 de octubre de 2021.Fecha de aceptación: 09 de noviembre de 2021.Fecha de publicación: 08 de diciembre de 2021

Hepatitis infecciosa en niños y adolescentes en América Latina

El virus de la hepatitis B es un virus altamente infeccioso cuyo estado de portador crónico conlleva a la cirrosis y el cáncer de hígado y esto se da en plazos más cortos si está asociado al virus D. Nuestro país tiene en promedio una endemicidad intermedia, aunque hay áreas de alta, mediada y baja endemicidad; sin embargo, la migración de personas entre estas áreas, está dispersando la infección. Debe destacarse en el país la transmisión horizontal en niños de áreas endémicas y la baja transmisión vertical, lo que es una ventaja para proteger tempranamente con la vacuna. La vacuna disponible contra HBV es eficaz y segura, y siendo la vacunación una de las intervenciones más costo efectivas, se han desarrollado programas de vacunación piloto en el país, con un significativo impacto sobre la tasa de infección por lo que amerita ampliar la población objetivo a inmunizar, como son los adolescentes y jóvenes y grupos de riesgo de manera que se acorten los periodos para eliminar la infección por HBV y por tanto sus secuelas crónicas. Hay avances en la prevención, pero aún queda que hacer con los portadores crónicos. Habiendo perspectivas terapéuticas tanto para los HBeAg positivos y HBeAg negativos, será pertinente plantear programas de tratamiento y de otro lado evaluar todas las intervenciones efectuadas. Estos son los temas que se incluyen en esta revisión

Added value in higher education institutions in Bogotá

Los resultados alcanzados por los estudiantes en la prueba Saber Pro han propiciado el denominado ranking de universidades, lo que ocasiona tensiones entre estas y en su interior, por mostrar avances diferenciales en los resultados alcanzados en las competencias genéricas y específicas examinadas. El presente estudio muestra un análisis descriptivo de los desempeños del componente matemático en las pruebas Saber 11 (matemáticas) y Saber Pro (razonamiento cuantitativo) desde el año 2012 a 2017. Se revisó un total de 528.197 estudiantes de 178 instituciones de Bogotá. Las variables estudiadas incluyen información del individuo (género, condición laboral, condición socioeconómica) y de la institución (carácter oficial y no oficial). Los resultados obtenidos presentan una correlación positiva en los resultados de las dos pruebas en diferentes años, mejores desempeños en condiciones socioeconómicas altas, similitud en resultados en cuanto a su situación laboral (si trabajan o no) y mayores resultados en las instituciones de carácter oficial nacional.Abstract: The results achieved by the students in the Saber Pro test have led to the so-called ranking of universities, which causes tensions between them and within them, by showing differential advances in the results achieved in the generic and specific competencies examined. This study shows a descriptive analysis of the performance of the mathematical component in the tests Saber 11 (mathematics) and Saber Pro (quantitative reasoning) from 2012 to 2017. A total of 528,197 students from 178 institutions in Bogotá were reviewed. The variables studied include information on the individual (gender, employment status, socioeconomic status) and on the institution (official and unofficial). The results obtained show a positive correlation in the results of the two tests in different years, better performance in high socioeconomic conditions, similarity in results regarding their employment situation (whether they work or not) and higher results in the national official institutions

Interrelated Factors Affecting Quantitative Reasoning Scores on the 2016 Saber Pro for Students in Conflict Zones

Dados los recientes acuerdos de paz y todos los procesos llevados a cabo a razón del posconflicto, es necesario indagar por el estado de la educación para cumplir los retos que le atañen. Es así pertinente estudiar los factores que inciden en los desempeños de los estudiantes –en las pruebas Saber Pro, en los componentes lectura crítica, razonamiento cuantitativo, competencias ciudadanas e inglés– que residen en los municipios inmersos en el conflicto y que presentaron las pruebas en el año 2016. A partir de los modelos jerárquicos lineales se analizará la relación de las variables en cuanto a estudiante, institución (universidad de procedencia) y zona, dando cuenta de los aspectos que intervienen en los resultados obtenidos. Por estudios previos se tiene que variables relacionadas con el estudiante y con la institución son determinantes en el desempeño, de modo que en este estudio se examinará la incidencia de las variables concernientes a la zona de residencia; además de las relacionadas con estudiante y universidad en el desempeño académico.**Given the recent peace accords and all of the processes undergone due to the post-conflict, it is necessary to investigate the state of education to meet the challenges that accompany these changes. It is thus pertinent to study the factors that coincide with student performance (in Saber Pro exams, the components of critical reading, quantitative reasoning, citizen competencies, and English) for students who live in municipalities immersed in the conflict and who took the exams in 2016. Based on linear hierarchical models, variables are analyzed regarding the student, the institute (university of study) and the region, thus providing an account of the aspects that influence the results obtained. From previous studies, it has been ascertained that variables related to the student and the institute are determinants for performance. As such, this study will examine the coincidence of variables concerning the area of residence, in addition to those related to student and university, that affect academic performance

Invasive Fusariosis in Nonneutropenic Patients, Spain, 2000-2015

Invasive fusariosis (IF) is associated with severe neutropenia in patients with concurrent hematologic conditions. We conducted a retrospective observational study to characterize the epidemiology of IF in 18 Spanish hospitals during 2000-2015. In that time, the frequency of IF in nonneutropenic patients increased from 0.08 cases per 100,000 admissions in 2000-2009 to 0.22 cases per 100,000 admissions in 2010-2015. Nonneutropenic IF patients often had nonhematologic conditions, such as chronic cardiac or lung disease, rheumatoid arthritis, history of solid organ transplantation, or localized fusariosis. The 90-day death rate among nonneutropenic patients (28.6%) and patients with resolved neutropenia (38.1%) was similar. However, the death rate among patients with persistent neutropenia (91.3%) was significantly higher. We used a multivariate Cox regression analysis to characterize risk factors for death: persistent neutropenia was the only risk factor for death, regardless of antifungal therapy

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio