Evaluación financiera con opciones reales para la aplicación de la lluvia sólida: el caso del aguacate en Michoacán

The objective of this study was to perform a financial analysis of the use of solid rain (potassium polyacrylate)with the real options method, to deal with price volatility and water scarcity for avocado production (Perseaamericana Mill.) in the state of Michoacán. The analysis is based on field data for extensive farming and afinancial evaluation to decide the most convenient, economic, social and environmentally sustainable optionfor the project. The results from the study indicate that the incorporation of the polymer increased theefficiency in water use by 50%, decreased costs by 65%, and increased agricultural productivity by 30%. Thecash flow (CF) at present value of the project with the option of investing in this technology is $3,261,608.13and without the option it is$3,000,200.00. The Net Present Value (NPV) changes to $1,726,526.50, whichelevates the value of the project by$57,326.50, so that the hypothesis of financial viability of the project isproven. The study concludes that it is possible to increase the profitability in the cultivation of avocado withthe use of solid rain, in order to deal with water scarcity and price volatility in the study period.El objetivo de esta investigación fue realizar un análisis financiero con el método de opciones reales del uso de la lluvia sólida (poliacrilato de potasio) para enfrentar la volatilidad de precios y la escasez de agua para la producción de aguacate (Persea americana Mill.) en el Estado de Michoacán; el análisis está basado en datos de campo para cultivos extensivos y una evaluación financiera para decidir la opción más conveniente, económica, social y ambientalmente sostenible para el proyecto. Los resultados de la investigación indican que la incorporación del polímero aumentó la eficiencia en el uso del agua en 50 %, disminuyó costos en 65 % y aumentó la productividad agrícola en 30 %. El flujo de efectivo (FC) a valor presente del proyecto con la opción de invertir en esta tecnología es de $3,261,608.13 y sin la opción es$3,000,200.00. El valor Actual Neto (VAN) cambia a $1,726,526.50, lo que eleva el valor del proyecto en$57,326.50, por lo que se comprueba la hipótesis de la viabilidad financiera del proyecto. Se concluye que es posible aumentar la rentabilidad en el cultivo de aguacate con el uso de lluvia sólida haciendo frente a la escasez de agua y a la volatilidad de precios en el periodo de estudio

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

Complement component C4 structural variation and quantitative traits contribute to sex-biased vulnerability in systemic sclerosis

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER), "A way of making Europe".Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort. Our results showed that higher C4 CN confers protection to SSc, and deviations from CN parity of C4A and C4B augmented risk. The protection contributed per copy of C4A and C4B differed by sex. Stronger protection was afforded by C4A in men and by C4B in women. C4 CN correlated well with its gene expression and serum protein levels, and less C4 was detected for both in SSc patients. Conditioned analysis suggests that C4 genetics strongly contributes to the SSc association within the major histocompatibility complex locus and highlights classical alleles and amino acid variants of HLA-DRB1 and HLA-DPB1 as C4-independent signals

PENSAMIENTO CRÍTICO EN LA INVESTIGACIÓN CIENTÍFICA Y ACADÉMICA COLECCIÓN CIENTÍFICA EDUCACIÓN, EMPRESA Y SOCIEDAD

PENSAMIENTO CRÍTICO EN LA INVESTIGACIÓN CIENTÍFICA Y ACADÉMICA COLECCIÓN CIENTÍFICA EDUCACIÓN, EMPRESA Y SOCIEDAD Primera Edición 2023 Vol. 21 Editorial EIDEC Sello Editorial EIDEC (978-958-53018) NIT 900583173-1 ISBN: 978-628-95884-1-5 Formato: Digital PDF (Portable Document Format) DOI: https://doi.org/10.34893/e1150-3660-8721-s Publicación: Colombia Fecha Publicación: 13/09/2023 Coordinación Editorial Escuela Internacional de Negocios y Desarrollo Empresarial de Colombia – EIDEC Centro de Investigación Científica, Empresarial y Tecnológica de Colombia – CEINCET Red de Investigación en Educación, Empresa y Sociedad – REDIEES Revisión y pares evaluadores Centro de Investigación Científica, Empresarial y Tecnológica de Colombia – CEINCET Red de Investigación en Educación, Empresa y Sociedad – REDIEE

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Médico - Paciente 4 - ME06 201102

El objetivo de la línea de cursos Médico - Paciente es formar médicos íntegros bajo la filosofía de la Atención Primaria en Salud, que actúen como agentes de cambio en los diversos campos de acción del profesional médico. La APS propugna la necesidad de brindar una atención de salud basada en los valores de equidad, solidaridad y el derecho al más alto nivel de salud posible; ello implica que el futuro profesional tenga una visión holística del proceso salud enfermedad y, que entre otras cosas, reconozca la importancia de la promoción y prevención, del trabajo intersectorial y de la atención integral e integrada. El curso Médico Paciente 4 (MP4) hace uso de la metodología de la reflexión con la cual nutre al alumno de conocimientos teóricos, lo expone a la realidad y finalmente fomenta el desarrollo de un análisis crítico de la experiencia vivida. En el curso Médico Paciente 3 el alumno conoció las estrategias en salud para el binomio madre-niño, ahora en MP4, continuará su aprendizaje en el área de enfermedades no transmisibles y enfermedades infecciosas; continuará explorando la salud mental y sus determinantes, perfeccionará sus habilidades comunicativas y profundizará en su sentido ético y humano

Respuesta ovulatoria, estado de desarrollo y calidad de embriones de ovejas Pelibuey superovuladas suplementadas con ácidos grasos poliinsaturados

This study evaluated the effect of adding polyunsaturated fatty acids (PUFAs) to the diet on the number of corpora lutea, total cells and embryos collected, development and morphological quality of embryos recovered from superovulated Pelibuey ewes. Twentysix (26) Pelibuey ewes were randomly distributed into two groups: 1) (control) Diet based on grass and a supplement without fatty acids (WFA) and group 2) Same diet as WFA plus 4 % of total dry matter of the diet as corn oil as a source of PUFAs. The estrous cycle was synchronized with two injections of PGF2a. The superovulation (SO) treatment began on d 10 of the estrous cycle with 200 mg of FSHp, in decreasing doses for 4 d. On the third day of SO treatment, 15 mg of PGF2a were administered, and ewes were mated to a fertile ram. Embryos were collected on d 6 after mating. Numbers of CL (14.73 +- 1.87 vs 10.73 +- 1.42), total cells collected (9.18 +- 2.16 vs 4.18 +- 1.36) and EMB (6.72 +- 1.78 vs 3.09 +- 1.36) were higher (PSe evaluó el efecto de ácidos grasos poliinsaturados en la dieta, sobre número de cuerpos lúteos, células y embriones totales, estado de desarrollo y calidad morfológica de embriones recuperados de ovejas superovuladas. Veintiséis (26) ovejas Pelibuey se distribuyeron aleatoriamente en un grupo testigo que recibió una dieta a base de pasto y concentrado (SA, n=13) y un grupo experimental alque se le adicionó, en el concentrado, 4 % de aceite de maíz (AM, n=13) del total de la materia seca de la dieta. El ciclo estral se sincronizó con dos inyecciones de PGF2a. Las ovejasfueron superovuladas el día 10 del ciclo estral, con 200 mg oveja-1 de FSHp, en dosis decrecientes, por cuatro días, al tercer día, se aplicaron 15 mg de PGF2a. Las hembras fueron servidas por monta natural. Los embriones se colectaron seis después del servicio. El número de cuerpos lúteos, células colectadas totales y embriones fueron superiores (P0.05) sobre la calidad morfológica embrionaria. La adición de aceite de maíz, rico en ácidos grasos poli insaturados, favorece el número de cuerpos lúteos, células colectadas totales y embriones, además incrementa el número de embriones en estado de mórula

COVID-19 case fatality rate is significantly reduced in high-altitude Andean populations of Bolivia, Colombia, Ecuador, Perú; and México in an ecological study

Previous epidemiological studies have shown that the incidence and severity of COVID-19 decrease significantly with high altitude. To date, the impact of high altitude on mortality caused by COVID-19 remains debated. This work evaluated the impact of high altitude residency on COVID-19 mortality and recovery rates in several Andean countries and México. For this purpose, a multinational ecological study of official data from Bolivia, Peru, Colombia, Ecuador, and Mexico was performed from the beginning of the pandemic until the end of 2020. The case fatality rate (CFR) of populations above 2,500 m and below 1,000 m was compared. Our results show that CFR decreases, and there is a higher recovery rate in populations located above 2,500 m in all five countries. Based on this study and multiple other references, we conclude that mortality caused by COVID-19 is lower in high-altitude Andean populations, and in the high-altitude municipalities of Mexico than in the lowlands of all these countries