Los proyectos inmobiliarios como propuestas metodológicas: Un enfoque desde la planificación y gerenciamiento

La presente investigación presenta un análisis del complemento al estudio del diagnóstico de la actividad inmobiliaria en la ciudad de Quito, habiendo analizado varios parámetros que fueron de vital importancia para estructurar una propuesta metodológica para planificar y gerenciar proyectos inmobiliarios, analizamos a los proyectos en sus 5 estructuras: técnico, administrativo, legal, comercial, y financiero.Cada una de las estructuras tiene su particularidad y es necesario mitigar cualquier tipo de riesgo inherente a la actividad inmobiliaria, que el proyecto se desarrolle con la menor probabilidad de un fracaso, es así que se logró establecer parámetros de medición bajo los cuales se pueden considerar equilibrios que un proyecto inmobiliario debe cumplir.Finalmente se realizó un análisis financiero integral, la composición de las estructuras de costos de un proyecto y el análisis de sus fuentes de financiamiento, se planteó un caso de estudio para analizar el comportamiento de un desarrollo inmobiliario con datos reales bajo diferentes escenarios que son los que se aplican en el día a día y que se dan en el sector de la construcción, todos estos análisis fueron desarrollados no como un análisis de teoría, al contrario se aplicó la teoría en casos de la vida real, con este análisis tenemos la capacidad de tomar la mejor decisión al momento de evaluar un proyecto y una guía muy práctica para aquellos inversionistas que desean invertir en la construcción

Turismo y Género. Una mirada desde Iberoamérica

En las últimas cuatro décadas ha crecido el interés de la academia, gobiernos y organizaciones internacionales por estudiar cómo ha sido, en qué circunstancias y qué efectos ha traído la incorporación de las mujeres al turismo. De esta forma se inicia un debate internacional en el que se cuestionan, por un lado, los efectos negativos de esta actividad en la vida de las mujeres y, por el otro, se realzan beneficios económicos que mejoran su calidad de vida y la de sus familias. A pesar del interés y la importante participación de mujeres en el sector turístico, aún son insuficientes los estudios enfocados en explicar y evidenciar su situación laboral. En este contexto, surge la idea de publicar un libro que compilara trabajos recientes en torno a las condiciones de las trabajadoras en el sector turístico de Iberoamérica.Esta obra se compone de tres secciones, Aproximaciones teórico metodológicas, Mujer y turismo en zonas rurales y La mujer en empresas turísticas, cuyas investigaciones abordan distintos temas para evidenciar los problemas enfrentados por las mujeres, proponer diversas soluciones y comprender su escenario laboral. En la primera sección, hay dos capítulos que proponen marcos teóricos para analizar el empoderamiento de las mujeres en el turismo rural. Los resultados de investigaciones de la segunda sección visibilizan las desigualdades, reflexionan y proponen acciones para mejorar las condiciones de las trabajadoras turísticas. En la última, en los tres capítulos, concentrados en las actividades empresariales, se estudian las desventajas y obstáculos de la empleada en alguna compañía turística.Universidad Autónoma del Estado de México

Immunohistochemical analysis of the inflammatory reaction within the implantation bed of a collagen hemostatic biomaterial

Current research on medical biomaterials have shown that the physical and chemical characteristics of biomaterials determine the body inflammatory cellular reaction after their implantation. The aim of this study was to evaluate the individual effects of the physical characteristics over the initial biomaterial-cellular interaction and the inflammatory cellular reaction. For this purpose, an equine-derived collagen hemostatic sponge (E-CHS) was modified by pressing and evaluated using ex vivo, in vitro and in vivo methods. The E-CHS was pressed by applying constant pressure (6.47± 0.85 N) for 2 min using a sterile stainless-steel cylinder and cut in segments of 1cm2. Subsequently, E-CHS and the pressed equine-derived collagen hemostatic sponge (P-E-CHS) were studied as two independent biomaterials and compared to a control group (CG). A blood concentrate containing inflammatory cells known as platelet rich fibrin (PRF) was used to mimic the initial biomaterial-cell interaction and to measure the absorption coefficient of the biomaterials to liquid PRF (iPAC). Additionally, the biomaterials were cultivated together with PRF for 3 and 6 days to measure the induction of pro-inflammatory cytokines (TNF-α and IL-8). The results were obtained through enzyme-linked immunosorbent assay (ELISA) and histological methods. PRF cultivated without biomaterials served as the CG. Additionally, the biomaterials were evaluated in vivo using a subcutaneous model in Wistar rats and compared to sham operated animals (CG) representing physiologic wound healing. After 3, 15 and 30 days, the explanted samples were evaluated using histochemical and immunohistochemical (IHC) staining using the following markers: CD68 (pan macrophages), CCR7 (pro-inflammatory macrophages, M1), CD206 (pro-wound healing macrophages, M2) and α-Smooth Muscle Actin (α-SMA; vessel identification). After the mixture of liquid PRF with both biomaterials for 15 minutes, the ex vivo results showed that E-CHS was penetrated by cells, whereas P-E-CHS was cell-occlusive. Additionally, P-E-CHS induced a higher release of pro-inflammatory cytokines compared to liquid PRF alone (CG) and E-CHS after 3 days (P< 0.05). Although the biomaterial was pressed, the difference of the iPAC value did not show statistical differences. In vivo, the CG induced at day 3 a higher inflammatory response compared to the experimental groups (EG) (P< 0.05). The intergroup comparison showed that P-E-CHS induced a higher presence of macrophages (CD68+/CC7+) compared to E-CHS at day 3 (P< 0.05). Only CD68+/CCR7+ mononuclear cells (MNCs) were observed without multinucleated giant cells (MNGCs). After 15 days, the presence of macrophages (CD68+ P<0.01 /CCR7+ P<0.001 /CD206+ P<0.05) reduced considerably in the CG. On the contrary, the inflammatory response increased in the EGs (CD68+/CCR7+). The intergroup comparison showed that this increment was statistically significant when comparing E-CHS and P-E-CHS to the CG at day 15 (P<0.01 and P< 0.05 respectively). At this time point, a reduced number of MNGCs were observed in the EGs. In the CG no MNGCs were observed. Furthermore, E-CHS showed a faster degradation rate and was fully invaded by cells and vessels formed in its interior region. On the other hand, P-E-CHS remained occlusive to cell penetration and vessels were formed only in the periphery. After 30 days, the cellular reaction shifted to a higher number of M2 macrophages (CD260+) in all groups and a reduced presence of CD68+ and CCR7+ MNCs. Both biomaterials degraded and only small fragments were found in the implantation bed surrounded by MNGCs (CCR7+). These results are of high clinical relevance and show that changes in biomaterial properties have a significant impact on their interaction with the body. They also serve as insight into the possibility to develop versatile biomaterials with different applications. For example, E-CHs can be applied to support hemostasis in a bleeding alveolar socket and P-E-CHs by being cell occlusive and having a delayed degradation rate can be applied for guided bone and tissue regeneration

Orbital floor fractures: epidemiology and outcomes of 1594 reconstructions

Objective: The aim of this study was to retrospectively review the midface and orbital floor fractures treated at our institution with regard to epidemiological aspects, surgical treatment options and postoperative complications and discuss this data with the current literature. Study design: One thousand five hundred and ninety-four patients with midface and orbital fractures treated at the Department of Oral, Cranio-Maxillofacial and Facial Plastic Surgery of the Goethe University Hospital in Frankfurt (Germany) between 2007 and 2017 were retrospectively reviewed. The patients were evaluated by age, gender, etiology, fracture pattern, defect size, surgical treatment and complications. Results: The average patient age was 46.2 (± 20.8). Most fractures (37.5%) occurred in the age between 16 and 35. Seventy-two percent of patients were male while 28% were female. The most common cause of injury was physical assault (32.0%) followed by falls (30.8%) and traffic accidents (17.0%). The average orbital wall defect size was 297.9 mm2 (± 190.8 mm2). For orbital floor reconstruction polydioxanone sheets (0.15 mm 38.3%, 0.25 mm 36.2%, 0.5 mm 2.8%) were mainly used, followed by titanium meshes (11.5%). Reconstructions with the 0.15 mm polydioxanone sheets showed the least complications (p < 0.01, r = 0.15). Eighteen percent of patients who showed persistent symptoms and post-operative complications: 12.9% suffered from persistent hypoesthesia, 4.4% suffered from post-operative diplopia and 3.9% showed intra-orbital hematoma. Conclusion: Results of the clinical outcome in our patients show that 0.15 mm resorbable polydioxanone sheets leads to significantly less post-operative complications for orbital floor defects even for defects beyond the recommended 200 mm2

Comparison of different feedback modalities for the training of procedural skills in Oral and maxillofacial surgery: a blinded, randomized and controlled study

Background The feedback given to students plays an important role in their efficiency related to learning practical skills. In the present study, diverse feedback modalities have been investigated. Our hypothesis is that individualized and unsupervised video feedback can produce a similar learning experience as performing practical skills in an oral and maxillofacial surgery setting with conventional direct expert feedback (control group). Methods This prospective, randomized, controlled, and blinded study compared direct expert feedback (DEF), individualized video feedback (IVF) and unsupervised video feedback (UVF). The participants were fourth-year dental students from University Goethe in Frankfurt. The students were assigned to one of the three feedback methods (n = 20 per group) using simple randomization. All participants watched an instruction video for an interdental (‘Ernst’) ligature and periphery venous catheterization. Next, the students were video recorded performing the tasks by themselves (pre-test). Following this, every student received feedback using one of the above-mentioned feedback modalities. The participants then performed the same task again while being video recorded (post-test) to measure the acquired competence. Six weeks later, the students participated in an objective structured clinical examination (OSCE) to evaluate their long-term knowledge retention. All examiners were blinded regarding the students’ instructional approach and their affiliation in terms of the learning group. Results For the interdental ligature, we found significant improvements in performance in each feedback modality group between the pre-test and post-test (p < 0.001). UVF had the strongest effect on performance time. The comparison between each group in the post-test showed no significant differences between the three groups. Conclusion This study showed that IVF and UVF can be considered an alternative or adjunct to conventional methods (i.e. DEF) when learning procedural skills in oral and maxillofacial surgery. However, DEF showed to be the most effective method of feedback and therefore preferable in teaching

AUDITORÍA CLÍNICA: UNA HERRAMIENTA COSTO EFICIENTE PARA CAMBIAR LA ODONTOLOGÍA EN VENEZUELA

La investigación es parte fundamental en la formación profesional de los odontólogos, su propósito es fomentar la educación continua y mejorar la calidad del tratamiento. Objetivo: Determinar la frecuencia en que estudios de tipo auditoria clínica han sido publicados en revistas científico-odontológicas venezolanas (RCOV). Introducir la auditoría clínica como una herramienta costo- efectiva para implementar mejoras de calidad en el cuidado de pacientes en la odontología a nivel nacional. Materiales y Métodos: Hemos realizado un estudio transversal retrospectivo de artículos publicados entre el período 2016 - 2020 en RCOV. Resultados: de 3 RCOV, con un total de 221 artículos publicados en 5 años, sólo 16 (N=7.2%) se consideraron de tipo auditoria clínica. Conclusión: Existe una baja frecuencia de artículos tipo auditorías en las RCOV. Es propósito de este artículo el presentar las auditorías clínicas como una herramienta de bajo costo, que, de una manera sencilla busca mejorar la calidad en la atención al paciente, es recomendación de los autores estimular la aplicación y publicación de este tipo de investigaciones desde la formación en pregrado para estimular la constante revisión y actualización de los protocolos en odontología

Revision of 116 orthognathic surgery patients operated on with the high-oblique sagittal osteotomy (HOSO): a retrospective case series (PROCESS-compliant article)

Background: The high-oblique sagittal osteotomy (HOSO) is an alternative to a bilateral sagittal split osteotomy (BSSO). Due to its novelty, there are no long-term studies which have focused on describing the incidence and type of complications encountered in the post-operative follow-up. The aim of this retrospective study is to analyze patients operated on with this surgical technique and the post-operative complications encountered. Patient and methods: The electronic medical records of all patients treated with orthognathic surgery at the Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany, between the years 2009 and 2016 were retrospectively reviewed. Results: A total of 116 patients fulfilled the inclusion criteria. The cases operated on with the standard osteosynthesis (X, Y, and straight) showed a complication rate of 36.37% (n = 4/11). The cases operated on with the HOSO-dedicated plates (HOSO-DP) showed, in total, a complication rate of 6.67% (n = 7/105). The most common post-operative complication resulting from both fixation methods was a reduction in mouth opening and TMJ pain for 4.3%. During the first years of performing the surgery (2009–211), a variety of standard plates had material failure causing non-union or pseudarthrosis. No cases of material failure were observed in the cases operated on with the HOSO-DP. The statistical results showed a highly significant dependence of a reduction in OP-time over the years, when the HOSO was performed without additional procedures (R2 > 0.83, P < 0.0015). Conclusion: The rate of complications in the HOSO were shown to be comparable to the rate of complications from the BSSO reported in the literature. Moreover, the use of the ramus dedicated plate appears to provide enough stability to the bone segments, making the surgery safer. Clinical relevance: The HOSO needs to be considered by surgeons as an alternative to BSSO. Once the use of the HOSO-DP was established, the rate of complications and the operation time reduced considerably

Epidemiological approach to nematode polyparasitism occurring in a sympatric wild ruminant multi-host scenario

© The Author, 2021This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by /4.0/ This document is the Accepted version of a Published Work that appeared in final form in Journal of Helminthology. To access the final edited and published work see https://doi.org/10.1017/S0022149X21000183The epidemiology behind multi-host/multi-parasite systems is particularly interesting to investigate for a better understanding of the complex dynamics naturally occurring in wildlife populations. We aimed to approach the naturally occurring polyparasitism of gastrointestinal nematodes in a sympatric wild ruminant scenario present in south-east Spain. To this end, the gastrointestinal tract of 252 wild ruminants of four different species (red deer, Cervus elaphus; mouflon, Ovis aries musimon; Iberian ibex, Capra pyrenaica and fallow deer, Dama dama) were studied in Cazorla, Segura y Las Villas Natural Park (Andalusia, Spain). Of the analysed animals, 81.52% were positive for parasite infection and a total of 29 nematode species were identified. Out of these, 25 species were detected in at least two host species and 11 parasitized all ruminant species surveyed. The multi-host interaction between these nematodes and the four host species is discussed under the perspective of host family-based differences