Centro Educativo con metodología Asiri en Lurín

Desde el colegio siempre pensé que la educación en el Perú era muy rígida, pasar horas de clases teóricas no compensaban a las practicas, además, mediante un censo nacional, uno de los problemas principales es que la infraestructura no produce un interés en el aprendizaje del alumno y que las aulas no funcionaban en las nuevas metodologías de enseñanza, es por esto, que empieza mi interés por buscar un edificio con ambientes para el confort del alumno. A partir del siglo XX, la educación tomo un camino distinto, aparecieron nuevas metodologías de enseñanza que motivara al alumno a aprender a su ritmo y que sobre todo le ayude en su formación persona y profesional. La metodología ASIRI lleva pocos años en el mercado educativo, pero con una ardua investigación sobre la psicología y el aprendizaje del niño, el cual me pareció interesante como este modo de educación repercute en los alumnos, teniendo en cuenta su formación espiritual personal, su aprendizaje cultural y profesional. El distrito de Lurin, actualmente, se encuentra en vías de desarrollo y en la búsqueda de integrar nuevas escuelas privadas; el objetivo de esta tesis es la construcción de una escuela con la metodología ASIRI a los niveles socioeconómicos bajos para demostrar que estas nuevas enseñanzas también pueden ser aptas en bajos recursos.When I was at school, I always thought that the education in Peru was very strict, to spend hours attending theoretical classes did not outweigh the practice. Moreover, because of a national poll, I learnt that one of the main problems was the infrastructure which did not raise interest in the student’s learning, and the classrooms were not appropriate to the new approaches of teaching. This is why my interest in looking for an adequate building started, with enough comfort for the students. Since the beginning of the twentieth century, the education has taken a different road. New methods of teaching have come to light, to motivate students to learn at their own pace, but overall to help them in their development as a professional and a human being. The ASIRI methodology has been in the educative market for few years; however, with deep investigation about the psychology and learning process of the child, it seemed to me interesting to know how this teaching approach affects in the students, taking into account their spiritual formation as well as culturally and professionally. The district of Lurin, currently, is in a stage of development and search for integrating new private schools. The objective of this thesis is the construction of a school which offers the ASIRI methodology, focused on people who have low levels of income. This is to demonstrate that this new learning methodology can also be used with children who do not have enough economical resources.Tesi

TRATAMENTO DA ERLIQUIOSE CANINA DE OCORRÊNCIA NATURAL COM DOXICICLINA, PRECEDIDA OU NÃO PELO DIPROPIONATO DE IMIDOCARB

Canine ehrliquiosis has become one of most important infectious diseases, especially due to its increasingly prevalence amongst dogs. Many treatment protocols have been proposed, but the association of imidocarb and doxycycline is frequently used because it shows an adequate therapeutic response. However, imidocarb can not be prescribed to some patients, which represents a paradox for many clinicians. The aim of this study was to evaluate the clinical response of doxycycline, preceded or not by imidocarb, for treating canine ehrlichiosis. Two groups of nine dogs were composed: the first was treated with doxycycline, whereas the second was treated with doxycycline and imidocarb. Results showed that both treatments were satisfactory, demonstrating that the clinical response did not depend on the use of imidocarb in the experiment.A erliquiose tem despontado como uma das mais importantes enfermidades infecciosas, devido ao aumento da sua prevalência entre os cães. Diversos tratamentos já foram propostos para a doença, sendo que a associação de imidocarb e doxiciclina é rotineiramente empregada, apresentando adequada resposta terapêutica. Entretando, em alguns pacientes, o imidocarb não pode ser utilizado devido aos seus efeitos hepatotóxicos, representando um paradoxo para muitos clínicos. Com o objetivo de avaliar a resposta clínica da doxiciclina, precedida ou não do imidocarb, em casos de erliquiose canina, constituiu-se dois grupos de nove cães, sendo um deles tratado com doxiciclina e o outro com doxiciclina e imidocarb. Observou-se que ambos os tratamentos resultaram em melhora clínica. Assim, concluiu-se que neste estudo, a resposta terapêutica foi indiferente quanto ao uso ou não do imidocarb nos casos de erliquiose canina

Estudo e otimização de uma pilha de combustível de pequena potência (10W) e sua integração em equipamento portátil

Trabalho Final de Mestrado para obtenção do grau de Mestre em Engenharia MecânicaCom o presente trabalho pretende-se, em termos globais, contribuir para o aprofundamento do conhecimento sobre as pilhas de combustível a hidrogénio através do estudo de uma pilha de combustível de pequena potência (10W) e a sua integração em equipamento portátil. Em termos estruturais, de uma forma geral, esta dissertação engloba três partes distintas, uma parte inicial na qual se procede a uma revisão de literatura, uma segunda parte, na qual é efetuado um estudo acerca da implementação da pilha de combustível a hidrogénio no equipamento portátil escolhido, por fim, uma terceira parte na qual é apresentada uma simulação do funcionamento dessa pilha com a devida discussão sobre os resultados obtidos, bem como sobre as limitações do estudo. Foram delineados três objetivos para este trabalho: o estudo teórico das pilhas de combustível, composto pelo estudo do seu princípio de funcionamento, das suas características, do tipo de combustível, das aplicações e dos desafios existentes neste tipo de tecnologia; o estudo comparativo entre as pilhas de combustível e outras tecnologias no mercado; e a implementação de uma pilha a hidrogénio num equipamento portátil escolhido por mim e estudo das suas características em funcionamento. A implementação de uma pilha de combustível a hidrogénio num equipamento portátil foi conseguida através do recurso ao programa Matlab®. Assim, foi possível a simulação do funcionamento da pilha para o equipamento selecionado. A simulação permitiu analisar e compreender o processo no interior da pilha de hidrogénio e o que esta transmite para o equipamento portátil. Em termos de resultados, estes foram suficientes para se ajuizar sobre as curvas características típicas de uma pilha de hidrogénio, nomeadamente da variação da corrente e da tensão com a variação de carga aplicada na pilha de hidrogénio.Abstract: The intention with the present work, in global terms, is to contribute for a more profound understanding about the hydrogen fuel cells from the studies of a low power fuel cell (10W) and its integration on portable equipment. In structural terms, in a general way, this thesis is assembled in three distinct parts, one consisting in a literature revision, a second in a study about the implementation of a hydrogen fuel cell in a particularly chosen portable equipment, and a third consisting in a simulation and discussion of obtained results of a fuel cell operation as well as study shortfalls. There were three objectives to be considered for this work: the theoretical study of the fuel cell, consisting on the: (i) study of the operation principle, (ii) main features, (iii) fuel type, (iv) existing applications and (v) technology challenges; the study of its functioning characteristics and also the comparative study between fuel cells and other technologies available in the market and the implementation of a hydrogen fuel cell in a portable equipment chosen by me. The implementation of a hydrogen fuel cell in a portable equipment was only possible resorting to the Matlab® program. Therefore, it was possible to simulate in the selected equipment the functioning of the fuel cell. The simulation allowed the analysis and the understanding of the interior process of the hydrogen fuel cell and what it provides to the portable equipment. Concerning results, these were more than enough to get the typical outline of the characteristic curves of a hydrogen fuel cell, mostly about the current and tension variation with the charge variation applied the hydrogen fuel cell

ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

Clonagem do gene p28 e análise da expressão da proteína recombinante a partir da amostra Jaboticabal de Ehrlichia canis e sua aplicação no diagnóstico da erliqueose canina

O presente estudo objetivou clonar e analisar a expressão do gene p28 da amostra Jaboticabal de Ehrlichia canis e avaliar sua utilização no diagnóstico molecular e sorológico da erliquiose canina. A PCR, baseada no gene p28 de E. canis, foi capaz de detectar o DNA de um único parasita entre um bilhão de células. Amostras sangüíneas de cães com suspeita clínica de erliquiose foram testadas pela PCR, baseada no gene p28 e pela nested PCR para detecção do gene 16S rRNA. O fragmento amplificado do gene p28 foi observado em 51,25% (n=41) das 80 amostras examinadas, e todas elas foram positivas para o gene 16S rRNA de E. canis, entretanto, em outros 21,25% (n=17) das amostras apenas o gene 16S rRNA foi detectado. A caracterização molecular do gene p28 mostrou similaridade com outras amostras de E. canis. Para a expressão da proteína recombinante P28, foram testados dois sistemas diferentes com linhagens de Escherichia coli BL21(DE3), BL21 Star(DE3)pLysS, BL21(DE3) pLysS e BL21-CodonPlus(DE3)-RIL. A análise pelo Western-blotting revelou reatividade de várias frações protéicas com anticorpo policlonal anti-E. canis. Porém, quando a membrana foi incubada com anticorpo monoclonal para detecção de moléculas de histidina, não houve reatividade, mostrando a ausência de expressão da proteína P28.The aim of this study was to clone and express the p28 gene of Ehrlichia canis Jaboticabal strain and evaluate its application in molecular and serological diagnosis of canine ehrlichiosis. The p28-based PCR was able to detect E. canis DNA of one parasite among one billion cells. Blood samples from dogs for which a diagnosis of canine ehrlichiosis was suspected were tested by p28-based PCR and by 16S rRNA-based nested PCR. Amplified fragment from p28 gene were observed in 51.25% (n=41) among 80 assayed samples and all of this positive samples were also positives for 16S rRNA gene of E. canis, however in 21.25% (n=17) only 16S rRNA gene was detected. The molecular characterization of p28 gene showed similarity with others strains of E. canis. Expression of P28 recombinant protein was tested with two different systems and in Escherichia coli BL21(DE3), BL21 Star(DE3)pLysS, BL21(DE3) pLysS and BL21-CodonPlus(DE3)-RIL strains. After expression induction, Westernblotting showed reactivity of some protein fractions against anti-E. canis antibodies. However, when samples were incubated with anti-histidine monoclonal antibodies, they did not react, demonstrating non-expression of P28 protein.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Ocorrência de Theileria equi em equinos criados na microrregião de Jaboticabal, Estado de São Paulo, Brasil

Amostras de sangue e soro de 170 equinos criados na microrregião de Jaboticabal, Estado de São Paulo, Brasil, foram coletadas e avaliadas pelo exame direto em esfregaço sanguíneo, reação de imunofluorescência indireta (RIFI) e nested reação em cadeia da polimerase (nPCR) para a detecção de infecções por Theileria equi. A concordância dos resultados entre os testes de diagnóstico foi verificada pelo teste de McNemar. Durante o exame dos esfregaços sanguíneos, parasitos foram detectados em seis (3,52%) equinos. Anticorpos anti-T. equi foram detectados em 100% das amostras de soros, com títulos variando entre 1:80 e 1:5120. O nPCR, baseado na sequência do gene do antígeno de merozoíto de T. equi (EMA-1), permitiu a visualização de produtos de amplificação espécie-específico em 108 (63,53%) equinos. Houve diferença altamente significativa (p < 0,0001) entre RIFI e nPCR; RIFI e esfregaço sanguíneo; e nPCR e esfregaço na detecção do parasito. O resultado do presente estudo indica que a infecção por T. equi está amplamente distribuída entre os equinos na microrregião de Jaboticabal, região Nordeste do Estado de São Paulo, Brasil.Blood and serum samples from 170 horses raised in the Jaboticabal microregion, São Paulo State, Brazil, were collected and tested by microscopic examination of blood smears, indirect fluorescent antibody test (IFAT) and nested polymerase chain reaction (nPCR) for Theileria equi infections. The association among the test results was verified by the McNemar test. During the examination of thin blood smears, parasites were detected in six (3.52%) horses. Anti-T. equi antibodies were detected in 100% sera samples, with titers ranging between 1:80 and 1:5120. The nPCR based on the T. equi merozoite antigen gene (EMA-1) allowed the visualization of specie-specific amplified product in 108 (63.53%) horses. All six samples judged positive microscopically were also positive for nPCR. Statistical analysis indicated general disagreement (p < 0.0001) between IFAT and nPCR; IFAT and blood smear; and nPCR and blood smear on the detection of parasite carriers. The results of the present study indicate that T. equi is widely spread among horses in the Jaboticabal microregion, Northeast region of São Paulo State, Brazil

Worldwide Disparities in Recovery of Cardiac Testing 1 Year Into COVID-19

BACKGROUND The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.OBJECTIVES The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide.METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. Multivariable regression was used to determine factors associated with procedure volume recovery.RESULTS Surveys were submitted from 669 centers in 107 countries. Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance; 22%-25% increases). Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.CONCLUSIONS Cardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. Pandemic-related psychological stress among providers is widespread and associated with poor recovery of cardiac testing. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes