Proportion of neonatal readmission attributed to length of stay for childbirth: a population-based cohort study

Objective: Most literature on length of stay (LOS) for childbirth focuses on ‘early’ discharge as opposed to ‘optimal’ time of discharge and has conflicting results due to heterogeneous definitions of ‘early’ discharge and differing eligibility criteria for these programmes. We aimed to determine the LOS associated with the lowest neonatal readmission rate following childbirth by examining the incidence pattern of neonatal readmission for different LOS using the Kitagawa decomposition. Design: Retrospective cohort study using administrative hospitalisation data. Setting: Canada (excluding Quebec) from 2003 to 2010. Patients: Term, singleton live births without congenital anomalies. Interventions: LOS for childbirth. Main outcome measure: Neonatal readmissions within 30 days of birth. Results: 1 875 322 live births were included. Neonatal LOS peaked at day 1 (47.3%) after vaginal birth and day 3 (49.3%) following caesarean section; 4.2% of infants were readmitted following vaginal birth and 2.2% after caesarean section. In 2008–2010, most readmissions occurred among infants discharged in the first 2 days (83.8%) following a vaginal birth and among infants discharged in the first 3 days (81.7%) following a caesarean birth. Readmissions increased from 4.1% in 2003–2005 to 4.6% in 2008–2010 among vaginal births and from 2.0% to 2.4% among caesarean births and occurred mostly due to changes in the day-specific readmission rates and not due to reductions in LOS. Conclusions: Patterns of readmission suggest that readmission rates are lowest following a 1–2-day stay following a vaginal birth and a 2–4-day stay following a caesarean birth given the outpatient support in the community

Caracterizacion del sistema de innovacion industrial de las empresas vitivinicolas exportadoras de la Septima Region

107 p.Las empresas se encuentran inmersas dentro de un entorno o sistema con el cual se relacionan constantemente. Estas interrelaciones de las empresas con el medio determinan el nivel de competitividad y el dinamismo de la industria. 1 objetivo principal de esta memoria es el conocer las capacidades innovativas de las empresas como centro del sistema e identificar claramente sus relaciones con los mecanismos de apoyo (Universidades, institutos, etc.), mecanismos de incentivos (presión competitiva, exigencia de los clientes, etc.) y analizar como se desarrolla la difusión de la innovación entre las empresas. Se aplico una serie de entrevistas y una encuesta a 15 empresas de gran importancia, entre empresas regionales y otras extraregionales (con presencia de alguna bodega en la Region). Refiriéndonos a los objetivos antes mencionados y específicamente al proceso innovador de las empresas podemos observar que las empresas poseen objetivos de largo plazo, como el mejoramiento de la calidad. Además las empresas se caracterizan en un gran porcentaje por planificar las actividades futuras de innovación, disponiendo recursos que estiman se incrementaran para I&D. En cuanto a la difusión de la información relacionada con la innovación que existe entre empresas se observo una gran confianza entre empresarios que se contrapone con un bajo nivel de cooperación entre empresas para realizar programas de innovación en conjunto. Es importante destacar que esta industria se abastece a traves de maquinarias e insumos principalmente extranjeros, lo cual refleja una deficiencia en la capacidad innovadora de los sectores conexos nacionales. Con relacion a Ios mecanismos de apoyo podemos decir que existe una debit relacion con las universidades nacionales como gestoras e implementadoras de innovacion, pero si se les considera como excelentes formadoras de profesionales, con caracteristicas apropiadas para cubrir las necesidades de las empresas. El gobierno ha jugado un papel discreto en este sistema de innovacion como mecanismo de incentivo, las empresas en su mayoria conocen y ocupan poco los mecanismos de apoyo que entrega el gobierno, con lo cual se han subutilizados. Es importante destacar que los factores mas motivadores para innovar, son las exigencies de los clientes extranjeros y el nivel de competencia en el extranjero. En general se aprecia un interes por parte del empresariado por aumentar el dinamismo del sistema, incrementando los lazos con las universidades, con el estado, y demas partes que aportan al sistema. De esta forma resulta de gran relevancia que aumente la colaboracion de todos los protagonistas, y de esta manera alcanzar un nivel mas elevado de competitividad que se hace cada vez mas indispensable, por la complejidad de los mercados y el endurecimiento de las condiciones de competencia a nivel mundial

Experience with tocilizumab in severe COVID-19 pneumonia after 80 days of follow-up: A retrospective cohort study

Objectives: To describe the clinical characteristics and predictors of major outcomes in patients treated with tocilizumab (TCZ) for severe COVID-19 pneumonia.Patients and methods: Case series of all sequential patients with severe COVID-19 pneumonia treated with TCZ at an Academic Spanish hospital (March 12 - May 2, 2020). Clinical outcomes: death, length of hospital stay. An early clinical response to TCZ (48-72 h after the administration) was assessed by variations in respiratory function markers, Brescia COVID Respiratory Severity Scale (BCRSS), inflammatory parameters, and patients' and physicians' opinion. Associations were tested by multiple logistic regression.Results: From a cohort of 236 patients, 77 patients treated with TCZ were included (median age 62 years (IQR 53.0-72.0), 64.9% were males), 42.9% had Charlson index ≥3; hypertension (41.6%), obesity (34.7%), and diabetes (20.8%). Median follow-up was 83.0 days (78.0-86.5), no patient was readmitted. ICU admission was required for 42 (54.5%), invasive mechanical ventilation in 38 (49.4%) and 10 patients died (12.9% global, 23.8% at ICU admitted). After multivariate adjustment, TCZ response by BCRSS (OR 0.03 (0.01-0.68), p = 0.028), and Charlson index (OR 3.54 (1.20-10.44), p = 0.022) has been identified as independent factors associated with mortality. Median of hospital stay was 16.0 days (11.0-23.0); BCRSS, physician subjective and D-dimer response were associated with shorter hospitalization stay.Conclusions: In a Mediterranean cohort, use of tocilizumab for severe COVID-19 show 12.9% of mortality. Early TCZ-response by BCRSS and low comorbidity were associated with increased survival. Early TCZ-response was related to shorter median hospital stay

EcID. A database for the inference of functional interactions in E. coli

The EcID database (Escherichia coli Interaction Database) provides a framework for the integration of information on functional interactions extracted from the following sources: EcoCyc (metabolic pathways, protein complexes and regulatory information), KEGG (metabolic pathways), MINT and IntAct (protein interactions). It also includes information on protein complexes from the two E. coli high-throughput pull-down experiments and potential interactions extracted from the literature using the web services associated to the iHOP text-mining system. Additionally, EcID incorporates results of various prediction methods, including two protein interaction prediction methods based on genomic information (Phylogenetic Profiles and Gene Neighbourhoods) and three methods based on the analysis of co-evolution (Mirror Tree, In Silico 2 Hybrid and Context Mirror). EcID associates to each prediction a specifically developed confidence score. The two main features that make EcID different from other systems are the combination of co-evolution-based predictions with the experimental data, and the introduction of E. coli-specific information, such as gene regulation information from EcoCyc. The possibilities offered by the combination of the EcID database information are illustrated with a prediction of potential functions for a group of poorly characterized genes related to yeaG. EcID is available online at http://ecid.bioinfo.cnio.es

EcID. A database for the inference of functional interactions in E. coli

The EcID database (Escherichia coli Interaction Database) provides a framework for the integration of information on functional interactions extracted from the following sources: EcoCyc (metabolic pathways, protein complexes and regulatory information), KEGG (metabolic pathways), MINT and IntAct (protein interactions). It also includes information on protein complexes from the two E. coli high-throughput pull-down experiments and potential interactions extracted from the literature using the web services associated to the iHOP text-mining system. Additionally, EcID incorporates results of various prediction methods, including two protein interaction prediction methods based on genomic information (Phylogenetic Profiles and Gene Neighbourhoods) and three methods based on the analysis of co-evolution (Mirror Tree, In Silico 2 Hybrid and Context Mirror). EcID associates to each prediction a specifically developed confidence score. The two main features that make EcID different from other systems are the combination of co-evolution-based predictions with the experimental data, and the introduction of E. coli-specific information, such as gene regulation information from EcoCyc. The possibilities offered by the combination of the EcID database information are illustrated with a prediction of potential functions for a group of poorly characterized genes related to yeaG. EcID is available online at http://ecid.bioinfo.cnio.es

Responsabilidad Social y Ciudadanía: Una perspectiva desde la universidad y la administración pública

La importancia de los estudios sobre ciudadanía se vincula con la imperiosa necesidad de fortalecer la democracia en todos aquellos espacios donde se manifiesta, principalmente en países como México, donde la falta de credibilidad en las instituciones democráticas ha permeado a la sociedad.Los desafíos contemporáneos requieren nuevos ajustes en diversos sentidos; al interior de las organizaciones es necesario adecuar los mecanismos con que interactúan frente a la sociedad en la que se desarrollan. Es requisito indispensable que el grueso de las organizaciones sociales se vinculen de manera directa con los problemas globales y nacionales: cambio climático, guerras, exigencias democráticas, movimientos sociales, pobreza, desempleo, inestabilidades políticas etc., ello les exige que se asuman como parte del complejo social, donde sus acciones repercuten de forma directa o indirecta

Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study

Objectives: This study aims to analyze the incidence of Post-acute COVID-19 syndrome (PCS) and its components, and to evaluate the acute infection phase associated risk factors.Methods: A prospective cohort study of adult patients who had recovered from COVID-19 (27th February to 29th April 2020) confirmed by PCR or subsequent seroconversion, with a systematic assessment 10-14 weeks after disease onset. PCS was defined as the persistence of at least one clinically relevant symptom, or abnormalities in spirometry or chest radiology. Outcome predictors were analyzed by multiple logistic regression (OR; 95%CI).Results: Two hundred seventy seven patients recovered from mild (34.3%) or severe (65.7%) forms of SARS-CoV-2 infection were evaluated 77 days (IQR 72-85) after disease onset. PCS was detected in 141 patients (50.9%; 95%CI 45.0-56.7%). Symptoms were mostly mild. Alterations in spirometry were noted in 25/269 (9.3%), while in radiographs in 51/277 (18.9%). No baseline clinical features behaved as independent predictors of PCS development.Conclusions: A Post-acute COVID-19 syndrome was detected in a half of COVID19 survivors. Radiological and spirometric changes were mild and observed in less than 25% of patients. No baseline clinical features behaved as independent predictors of Post-acute COVID-19 syndrome development

Avifauna del Centro de Biotecnología Agropecuaria C.B.A

El libro presenta la Avifauna presente en la sabana de occidente en el área de influencia del Centro de Biotecnología agropecuaria en Mosquera Cundinamarca, el cual se presenta cómo un refugio de biodiversidad en el que se encuentran aves, mamíferos, anfibios y reptiles. Se presentan fichas con información detallada asociada a clasificación taxonómica, orden, familia, especie, origen, nombre común, descripción, hábitat y ecología, hábitos alimenticios, estado de conservación y distribución geográfica.The book presents the Avifauna present in the western savannah in the area of influence of the Center for Agricultural Biotechnology in Mosquera Cundinamarca, which is presented as a biodiversity refuge where birds, mammals, amphibians and reptiles are found. Cards are presented with detailed information associated with taxonomic classification, order, family, species, origin, common name, description, habitat and ecology, eating habits, conservation status and geographical distribution.Acerca del semillero de investigación -- Generalidades de las aves -- Taxonomía -- Anatomía -- Importancia cultural -- Buenas prácticas para la observación de aves -- Ética del buen observador de aves -- Normas de comportamiento -- Responsabilidad del guía -- Las aves en la sabana de occidente, área de influencia Centro de Biotecnología Agropecuaria -- Metodología -- Avifauna del Centro de Biotecnología Agropecuariana121 página

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217