Agricultural eco-efficiency and water footprint- A case study of fifteen crops in the Chupaca province of Peru

The water footprint is an indicator of the impact of water use from its formation to its final destination. Agricultural eco-efficiency measures the efficient use of resources or materials available for crop production. Water's economic productivity analyses a product's efficient value as per its water supply and commercial value. The present research aimed to determine and relate the water footprint, economic productivity of water and agricultural eco-efficiency of 15 crops in the province of Chupaca - Peru. Georeferencing material was used for the delimitation of agricultural species, CROPWAT 8.0, CLIMWAT8.0, ArcGis 10.5 software, mathematical equations for the water footprint, agricultural eco-efficiency (Data Envelopment Analysis (DEA)) and economic productivity of water. The Total water footprint (TWF) of the fifteen crops was 1718237.01 m3/ton, likewise the BlueWF > GreenWF > GreyWF. In their economic outputs, gross value of production (GVP) > agricultural production (Ag-p) > economic rent agricultural (ERA) was verified. In environmental costs, water consumption that meets the needs of crops (Wc-Ag) > consumption of phytosanitary products (C-fly) > fertilizer consumption (C-fe) was determined. The average Agricultural eco-efficiency (Ag-Eec) and Economic water productivity (Ewp) were 89.8% and 0.046 PEN/m3 respectively. Statistical analysis between Ewp and Ag-Eec was rho = 0.18, t-test = 0.66 < 2.16 (α = 0.05; bilateral), and the correlation indicated that both activities are independent. The environmental costs and economic outputs of agricultural eco-efficiency did not influence the economic value of water.

ANÁLISIS TÉRMICO ÓPTIMO DE LA TRANSMISIÓN DEL CORONAVIRUS (COVID-19) DURANTE DÍAS DE CUARENTENA EN PERÚ

In this research is analyzed COVID-19 transmission by thermodynamic and energy balance between geographic areas and its correlation with possible COVID-19 transmission between 2 persons at least. In order to achieve parameters for medical doctors, as for example the minimal distance among two infected people, who have this virus, there were designed mathematical models that were based in statistical data to get information of COVID-19 propagation as the dependence on temperature of geographic areas, moreover the thermal effect of the minimal distance between two people avoiding COVID-19 infection. With this work, answers are sought to the questions: if it could be possible to find a relation between temperature and virus transmission? Or if it could be possible to get a correlation variable among thermal variables with minimal distance separation (it was described above) for two people? Hence, it is waited answers to these questions owing to be support for medical doctors, who are trying to find solution against COVID-19 propagation. It is worth mentioning that this research can be extended to more complex areas such as street markets, street fair or enclosed marketplaces, where products and services are sold, moreover, not every area has an air conditioning system in Peru. Nevertheless, in this research it is achieved the technique, how to solve this task: to obtain appropriated ventilation parameters as the dependence on the minimal distance that people need to be separated, according to avoid virus transmission between each other. Furthermore, it is suggested some geometrical/material characteristics for air filters and ultraviolet (UV) disinfection at the entrance of the main air duct.En esta investigación se analiza la transmisión de COVID-19 por equilibrio termodinámico y energético entre áreas geográficas y su correlación con la posible transmisión de COVID-19 entre al menos 2 personas. Con el fin de lograr parámetros para los médicos, como por ejemplo la distancia mínima entre dos personas infectadas que tienen este virus, se diseñaron modelos matemáticos basados en datos estadísticos para obtener información sobre la propagación de COVID-19 como la dependencia de la temperatura de áreas geográficas, además, el efecto térmico de la distancia mínima entre dos personas evitando la infección por COVID-19. Con este trabajo, se buscan respuestas a las preguntas: ¿Si fuera posible encontrar una relación entre la temperatura y la transmisión del virus? ¿O si fuera posible obtener una variable de correlación entre variables térmicas con una separación mínima de distancia (se describió anteriormente) para dos personas? Por lo tanto, se esperan respuestas a estas preguntas debido al apoyo de los médicos, que están tratando de encontrar una solución contra la propagación de COVID-19. Vale la pena mencionar que esta investigación puede extenderse a áreas más complejas como mercados y ferias abiertas al aire libre o mercados cerrados, donde se venden productos y servicios, además, no todas las áreas tienen un sistema de aire acondicionado en Perú. Sin embargo, en esta investigación se logra la técnica, cómo resolver esta tarea: obtener parámetros de ventilación apropiados como la dependencia de la distancia mínima que las personas necesitan para separarse, para evitar la transmisión del virus entre sí. Además, se sugieren algunas características geométricas / materiales para los filtros de aire y la desinfección mediante ultravioleta (UV) en la entrada del conducto de aire principal

ALGORITMO DE RECONSTRUCCIÓN DE EVENTOS PARA LA RECONSTRUCCIÓN 3D DE CORONAVIRUS (COVID-19), SEGÚN EL ESTUDIO DE SU REACCIÓN A TRAVÉS DEL TRATAMIENTO DE ANÁLISIS ANTIVIRAL

Esta investigación explica las aplicaciones de reconstrucción tridimensional (3D) para las imágenes de las familias COVID-19, según la búsqueda de la correlación entre el modelo matemático "evento por evento" con efecto antiviral sobre el virus, además, el modelo matemático obtenido de la reconstrucción 3D está correlacionado con "Un modelado matemático general para las respuestas inmunitarias". Por lo tanto, el algoritmo diseñado, proporciona apoyo a los médicos a través de un análisis gráfico y predicciones con respecto a "¿Qué sucede con el virus antes de aplicar una acción como los medicamentos contra la malaria?". Muchos países están tratando de encontrar la vacuna contra COVID 19; sin embargo, muchos países sólo tienen estrategias estadísticas dadas por las restricciones de desplazamiento de la población, lo cual no es suficiente para evitar la rápida  transmisión del virus. Por lo tanto, en esta investigación se propone un análisis matemático para tratar el virus mediante un modelo predictivo basado en la reconstrucción de imágenes 3D del COVID 19, correlacionada con aplicaciones de análisis antiviral. Como consecuencia del modelo diseñado, el médico puede predecir las respuestas de las células dañadas por el virus después de aplicar antivirales o plasma sobre ellas. El algoritmo proporcionado se elabora para ser un soporte para el tratamiento del COVID 19

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

The UN’s Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today’s gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.

BACKGROUND: Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. FINDINGS: Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9-3·0) for men and 3·5 years (3·4-3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78-0·92) and 1·2 years (1·1-1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. INTERPRETATION: Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. FUNDING: Bill & Melinda Gates Foundation

Comparison of PACS and Bone Ninja mobile application for assessment of lower extremity limb length discrepancy and alignment

PURPOSE: There are over 500 medically related applications (apps) for mobile devices. Very few of these applications undergo testing and peer-review for accuracy. The purpose of this study is to assess the accuracy of limb deformity measurements on the Bone Ninja app compared to PACS and to determine the intra- and inter-observer variability among different orthopaedic practitioners. METHODS: Four participants (attending, senior and junior resident, and physician assistant) measured the leg length (LL), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) of 48 limbs (24 patients), twice with both Bone Ninja and PACS. The difference between the measurements obtained with the Bone Ninja app and PACS were measured. We determined the consistency of the intra-observer intra-class correlation coefficient (ICC) for both systems. RESULTS: There were no statistical differences in leg length discrepancy (LLD), MPTA, or LDFA measurements between Bone Ninja and PACS (p = 0.96, 0.87, and 0.97, respectively). The intra-observer ICC for the LL, LDFA, and MPTA was similar between Bone Ninja and PACS (0.83, 0.89, and 0.96 vs. 0.96, 0.93, and 0.95, respectively). The inter-observer ICC was similar between Bone Ninja and PACS (0.95, 0.96, and 0.99 vs. 0.99, 0.98, and 0.98, respectively). CONCLUSIONS: This study demonstrates that Bone Ninja is an accurate educational tool for measuring LLD, LDFA, and MPTA. Both systems are reliable instruments for evaluating limb length differences and angles on standing radiographs for pre-operative deformity planning and education. This is the first study to evaluate the accuracy of Bone Ninja compared to the gold standard of PACS

Comparison of PACS and Bone Ninja mobile application for assessment of lower extremity limb length discrepancy and alignment.

PurposeThere are over 500 medically related applications (apps) for mobile devices. Very few of these applications undergo testing and peer-review for accuracy. The purpose of this study is to assess the accuracy of limb deformity measurements on the Bone Ninja app compared to PACS and to determine the intra- and inter-observer variability among different orthopaedic practitioners.MethodsFour participants (attending, senior and junior resident, and physician assistant) measured the leg length (LL), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) of 48 limbs (24 patients), twice with both Bone Ninja and PACS. The difference between the measurements obtained with the Bone Ninja app and PACS were measured. We determined the consistency of the intra-observer intra-class correlation coefficient (ICC) for both systems.ResultsThere were no statistical differences in leg length discrepancy (LLD), MPTA, or LDFA measurements between Bone Ninja and PACS (p&nbsp;=&nbsp;0.96, 0.87, and 0.97, respectively). The intra-observer ICC for the LL, LDFA, and MPTA was similar between Bone Ninja and PACS (0.83, 0.89, and 0.96 vs. 0.96, 0.93, and 0.95, respectively). The inter-observer ICC was similar between Bone Ninja and PACS (0.95, 0.96, and 0.99 vs. 0.99, 0.98, and 0.98, respectively).ConclusionsThis study demonstrates that Bone Ninja is an accurate educational tool for measuring LLD, LDFA, and MPTA. Both systems are reliable instruments for evaluating limb length differences and angles on standing radiographs for pre-operative deformity planning and education. This is the first study to evaluate the accuracy of Bone Ninja compared to the gold standard of PACS

Comparison of PACS and Bone Ninja mobile application for assessment of lower extremity limb length discrepancy and alignment.

PurposeThere are over 500 medically related applications (apps) for mobile devices. Very few of these applications undergo testing and peer-review for accuracy. The purpose of this study is to assess the accuracy of limb deformity measurements on the Bone Ninja app compared to PACS and to determine the intra- and inter-observer variability among different orthopaedic practitioners.MethodsFour participants (attending, senior and junior resident, and physician assistant) measured the leg length (LL), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) of 48 limbs (24 patients), twice with both Bone Ninja and PACS. The difference between the measurements obtained with the Bone Ninja app and PACS were measured. We determined the consistency of the intra-observer intra-class correlation coefficient (ICC) for both systems.ResultsThere were no statistical differences in leg length discrepancy (LLD), MPTA, or LDFA measurements between Bone Ninja and PACS (p&nbsp;=&nbsp;0.96, 0.87, and 0.97, respectively). The intra-observer ICC for the LL, LDFA, and MPTA was similar between Bone Ninja and PACS (0.83, 0.89, and 0.96 vs. 0.96, 0.93, and 0.95, respectively). The inter-observer ICC was similar between Bone Ninja and PACS (0.95, 0.96, and 0.99 vs. 0.99, 0.98, and 0.98, respectively).ConclusionsThis study demonstrates that Bone Ninja is an accurate educational tool for measuring LLD, LDFA, and MPTA. Both systems are reliable instruments for evaluating limb length differences and angles on standing radiographs for pre-operative deformity planning and education. This is the first study to evaluate the accuracy of Bone Ninja compared to the gold standard of PACS