Evaluation of corn production parameters and their spatial relationship with chemical attributes of the soil

The characterization of the soil spatial variability allows a better understanding of the relationships between the soil attributes and the environment. The objective of the study was to evaluate the spatial variability of corn production parameters and their relationship with soil chemical attributes. The study was carried out in the municipality of Miranda do Norte (MA, Brazil) in a Typic Plinthaquults. A mesh of 113 points was designed, taking samples at regular distances of 10 m, determining pH, organic material, P, K, Ca, Mg, and exchangeable acidity. The corn production parameters were ear weight, weight of 100 grains, and yield. The results were analyzed by means of descriptive statistics and geostatistical techniques. The pH and the weight of 100 grains were the only attributes with low variability. The sum of the bases did not show spatial dependence. The corn yield and the ear weight showed similar high correlation and spatial dependence. The production parameters showed a significant influence of the soil chemical attributes, principally those that define the acidity and the cations presence. The contour maps allowed the identification of the soil spatial attributes and their relationship to corn yield

Spatial variability of infiltration and its relationship to some physical properties

Water infiltration into soil is one of the basic factors for estimating irrigation intensity according to the plants’ requirements; this is aimed at avoiding problems of surface run-off and degradation. The purpose of the present investigation was to determine the spatial variation of infiltration and its relationship to some physical properties of soil by means of geostatistical techniques in Typic Plinthaquult soils having average texture and flat relief. A 113 point mesh was designed, having a regular distance of 10 m between points, samples being taken from 0 to 0.20 meters depth. Sand, silt and clay content, bulk density, macroporosity, microporosity and total porosity were determined. Infiltration tests were carried out in the field by means of a 15 cm diameter ring. Descriptive statistics and geostatistics were used for analysing the data. Infiltration, silt and microporosity data did not fit a normal distribution curve. Infiltration had high variability, having an average 36.03 mm h-1. Total porosity was 56.73%, this being the only property that did not show spatial dependency. The smallest ranges were observed for bulk density, macroporosity and microporosity, having values of less than 40 m. The smallest degrees of spatial dependence were observed for infiltration, silt and clay, evidence also being shown of the influence of silt and clay on infiltration rate. Contour maps were constructed; fitting them to the semivariogram models, together with studying the correlations, led to establishing re- lationships between the properties.La infiltración del agua en el suelo es uno de los factores básicos para estimar la intensidad de riego de acuerdo a los re- querimientos de las plantas, para evitar problemas de escorrentía superficial y de degradación. El objetivo del presente trabajo fue el de determinar la variabilidad espacial de la in- filtración y su relación con algunas propiedades físicas del suelo, mediante técnicas geoestadísticas, en un Typic Plinthaquults de textura media y relieve plano. Se diseñó una malla de 113 puntos, con distancia regular entre puntos de 10 m, tomando muestras entre 0-0,20 m de profundidad. Se determinaron contenidos de arena, limo y arcilla, densidad aparente, macroporosidad, microporosidad y porosidad total. La infiltración fue realizada en campo mediante anillo de 15 cm de diámetro. Los datos se analizaron por medio de estadística descriptiva y geoestadística. La infiltración, el limo y la microporosidad no se aproximaron a la distribución normal. La infiltración presentó alta variabilidad, con una media de 36,03 mm h-1. La porosidad total fue de 56,73%, siendo la única propiedad que no presentó dependencia espacial. Lo menores rangos se observaron para la densidad aparente, macroporosidad y microporosidad, con valores inferiores a 40 m. Los menores grados de dependencia espacial fueron apreciados en la infiltración, limo y arcilla, evidenciándose también la influencia del limo y la arcilla en la tasa de infiltración. Los mapas de contorno elaborados, cuando éstos se ajustan a modelos de semivariogramas, junto al estudio de las correlaciones, permite establecer relaciones entre las propiedades

Adaptación y validación del Inventario Maslach para el Desgaste Profesional-Encuesta para los Servicios de Salud

Objective: The objective of this study was to establish the psychometric properties of reliability and validity of the «Maslach Burnout Inventory-Human Services Survey» (MBI-HSS). Methods: The work was conducted by a process of translation and back-translation of the original instrument, instrument adaptation, translation and adaptation of the application manual, pilot study, and implementation of the adapted version of the instrument with 314 health professionals in Cali, according to the guidelines of the International Test Commission (ITC). Results: The results showed that the scale has good internal consistency (a=0.767); however, the dimension of «depersonalization» has the lowest internal consistency (a=0.518). Regarding validity, in comparing between the factor structure of the modified scale with the original version, we identified that the size of the validated version largely coincides with that of the original version; in the dimension of emotional fatigue, item 6 is excluded because it will be part of the depersonalization scale, items 15 and 21 were also excluded given their poor discriminatory ability. Conclusion: It is necessary to overcome the stability problems of the MBI-HSS depersonalization subscale in health professionals and reformulate the response options to make them more understandable for professionals within the Colombian context. Objetivo: El objetivo del presente estudio fue establecer las propiedades psicométricas de fiabilidad y validez del «Inventario Maslach para el Desgaste Profesional-Encuesta para los Servicios de Salud» (Maslach Burnout Inventory- Human Services Survey (MBI-HSS). Métodos: Se llevó a cabo un proceso de traducción-retrotraducción del instrumento original, adaptación del instrumento, traducción y adaptación del manual de aplicación, estudio piloto y aplicación de la versión adaptada del instrumento a 314 profesionales de la salud de Cali, de acuerdo con los lineamientos de la Comisión Internacional de Test (ITC). Resultados: Los resultados mostraron que la escala posee una buena consistencia interna (α=0.767). Sin embargo, la dimensión «despersonalización» tiene la menor consistencia interna (α=0.518). En relación con la validez, al comparar la estructura factorial de la escala adaptada con la versión original, se identificó que las dimensiones de la versión validada coinciden en buena medida con las de la versión original; en la dimensión cansancio emocional se excluye el punto 6 que hará parte de la dimensión despersonalización y se eliminan los puntos 15 y 21 por su poca capacidad discriminativa. Conclusión: Es necesario superar los problemas de estabilidad de la subescala de despersonalización para el MBIHSS en profesionales de la salud, así como reformular las opciones de respuesta para que sean más comprensibles para los profesionales en el contexto de Colombia

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Objetivo: describir los factores psicosociales asociados a diagnóstico dual (retraso mental – trastornos  mentales) en una muestra de adultos residentes en Cali. Método: participaron 50 díadas conformadas por  un adulto con diagnóstico dual (ADU) y su cuidador principal. Se emplearon el cuestionario para cuidadores  (CADIT), diseñado por los autores, y la Escala Integral de Calidad de Vida (Verdugo, Gómez y Arias, 2007)  adaptada a población de Cali por los autores de este estudio. Resultados: se encontró en el factor persona,  niveles adecuados de bienestar físico (66%), de adherencia al tratamiento (86%) y de autocuidado (82%);  satisfacción media en la relación individuo-contexto (54%). En el factor familia, se identificó un buen nivel de  satisfacción de necesidades y suficientes recursos para hacer frente a las situaciones de la vida diaria (84%),  adecuado funcionamiento familiar (86%) y en un 60% de la muestra la participación de la familia en la  rehabilitación del ADU se encontraba entre regular y deficiente. En el factor social, se encontraron apoyos  regulares en un 68% y una inclusión media en un 52% de la muestra. Conclusiones: a partir de los resultados de este estudio se plantea la necesidad de orientar los programas de intervención hacia el fortalecimiento de la relación familiar como apoyo principal para los ADU; la promoción de la autonomía del ADU dentro y fuera  de su núcleo familiar; y al desarrollo de políticas públicas que generen oportunidades educativas y laborales  para los ADU, que favorezcan su inclusión social.Objective: describe the psychosocial variables associated to a dual diagnosis (mental retardation – mental  disorders) in a sample of adults in the city of Cali. Method: fifty dyads took part, made up of one adult with  dual diagnosis (ADD) and their principal care taker. A care-taker’s questionnaire (CADIT), designed by the  authors was used together with the Integral Quality of Life Scale (Verdugo, Arias & Gómez, 2007) adapted by  the authors this study to the population of Cali. Results: The personal factor showed adequate levels of  welfare (66%), treatment adherence (86%) and self-care (82%); there was also medium satisfaction in the  individual-context relation (54%).In the family factor, the study revealed a good level of needs’ satisfaction  and sufficient resources to cope with dayto- day situations (84%), adequate family functioning (86%) and for  60% of the sample the family’s participation in the ADD’s rehabilitation registered between poor and  deficient. In the social factor regular support was found (68%) and a medium inclusion of 52% of the sample.  Conclusions: the results of this study manifest the need to manage intervention programs toward  strengthening family relationships as the main support for ADD, the promotion of ADD’s autonomy within  and outside the household, and the development of public policies that create educational and employment  opportunities for ADD, for their social inclusion

Relatório de condições sistemáticas de pacientes adultos. : Faculdade de Odontologia, Universidade de Antioquia, 2011

Introduction: The goal of this research project was to determine the prevalence and concordance of reports of a group of systemic conditions by means of Dental/Medical Records (mrs) and telephonic surveys (TS) in patients consulting at two adults’ clinics at the Faculty of Dentistry of the University of Antioquia. Methods: Cross-sectional study (n = 104). We evaluated clinical records and registered the 10 most frequent systemic diseases according to the epidemiological data in Medellin (Colombia). We used TS to corroborate previous information on the mrs. We measured the prevalence of the diseases and determined a concordance level between the results of mr and ts through a kappa index with a 95% confidence interval (95%CI); according to different variables. Results: The most prevalent systemic disease was ocular disease (58% ts and 30% mr, statistically significant p < 0.001) and the less prevalent one was hyperthyroidism (3% mr and 5% ts, no statistically significant). Kappa analyses showed the weakest concordance in the case of hyperthyroidism (0.22; 95%CI -0.38-0.82) and in case of ocular disease (0.37; 95%ci 0.20- 0.72). Variability in the prevalence and kappa indexes was observed related to gender, type of clinic and age interval. Conclusions: Variations in the reported prevalence between the mr and ts were found. This situation may be explained as originating in difficulties completing medical antecedents, which cause an underreporting in the MR.Introducción: el objetivo de esta investigación fue determinar la prevalencia y la concordancia en el reporte de condiciones sistémicas entre la historia clínica odontológica (hc) y la entrevista telefónica (et), en los pacientes que asisten a dos clínicas del adulto de la Facultad de Odontología de la Universidad de Antioquia. Métodos: estudio transversal (n = 104). Se evaluaron las hc y se registraron las diez condiciones sistémicas más frecuentes según registros epidemiológicos de Medellín. Se realizó et para verificar información de las hc. Se calcularon prevalencias y el nivel de concordancia entre resultados de la hc y la et mediante el índice kappa y su intervalo de confianza al 95% (ic95%), según variables. Resultados: la condición sistémica más prevalente fue la enfermedad ocular (58% según et y 30% según hc y diferencias significativas p < 0,001), y la menos prevalente fue el hipertiroidismo (3% según hc y 5% según et, sin diferencias significativas). El análisis kappa mostró que las concordancias más débiles se presentaron para el hipertiroidismo (0,22; ic95%-0,38-0,82) y la enfermedad ocular (0,37; ic95% 0,20-0,72). Se evidenciaron variaciones en los índices de concordancia de acuerdo con sexo, clínica y edad. Conclusiones: existen variaciones en las prevalencias reportadas por hc y por et debidas a dificultades a la hora de diligenciar los antecedentes médicos personales, que produjeron un subregistro en la hc.  Introdução: o objetivo desta pesquisa foi determinar a prevalência e a concordância no relatório de condições sistêmicas entre o prontuário médico odontológico e a entrevista telefônica (et) nos pacientes que vão a duas clínicas do adulto da Faculdade de Odontologia da Universidade de Antioquia. Métodos: estudo transversal (n = 104). Avaliaram-se os prontuários e se registraram as dez condições sistêmicas mais frequentes segundo registros epidemiológicos de Medellín. Realizou-se et para verificar informação dos prontuários. Calcularam-se prevalências e o nível de concordância entre resultados do prontuário e da et mediante o índice kappa e seu intervalo de confiança a 95% (ic95%), segundo variáveis. Resultados: a condição sistêmica mais prevalente foi a doença ocular (58% segundo et e 30% segundo prontuários e diferenças significativas p < 0,001), e a menos prevalente foi o hipertireoidismo (3% segundo prontuários e 5% segundo et, sem diferenças significativas). A análise kappa mostrou que as concordâncias mais fracas se apresentaram para o hipertireoidismo (0,22; ic95%-0,38-0,82) e a doença ocular (0,37; ic95%0,20-0,72). Evidenciaram- se variações nos índices de concordância de acordo com sexo, clínica e idade. Conclusões: existem variações nas prevalências relatadas pelo prontuário e pela et devidas a dificuldades na hora de diligenciar os antecedentes médicos pessoais, que produziram um sub-registro no prontuário

Investigações clínicas para o SUS, o Sistema Único de Saúde brasileiro

CONTEXTO E OBJETIVO: O desenvolvimento científico e tecnológico é crucial para avançar o Sistema Único de Saúde e promover qualidade de vida. Analisou-se como o Ministério da Saúde (MS) apoiou a pesquisa clínica para proporcionar autonomia, auto-suficiência, competitividade e inovação no complexo industrial produtivo da saúde, segundo a Política Nacional de Ciência, Tecnologia e Inovação em Saúde. TIPO DE ESTUDO E LOCAL: Estudo descritivo baseado em dados secundários, realizado no Departamento de Ciência e Tecnologia, Ministério da Saúde. MÉTODOS: O banco de dados gerencial de pesquisas do MS, PesquisaSaúde, foi analisado de 2002 a 2009, empregando a palavra chave "pesquisa clínica" nos campos "sub-agenda principal" ou "sub-agenda secundária". Foram encontrados 368 projetos, classificados em seis categorias: pesquisa biomédica básica, estudos pré-clínicos, pesquisa clínica expandida, ensaios clínicos, infraestrutura e avaliação de tecnologias em saúde. A partir da revisão estruturada sobre "financiamento da pesquisa clínica", resultados de países selecionados são apresentados e discutidos. RESULTADOS: O total investido foi R$140 milhões. A maioria dos projetos apoiou "pesquisa biomédica básica" e os maiores investimentos foram em "ensaios clínicos" e projetos de "infra-estrutura". O Sudeste deteve a maior proporção de projetos e recursos financeiros. Em alguns aspectos, o Brasil está à frente de outros países do BRICS (Rússia, Índia, China e África do Sul), sobretudo no estabelecimento da Rede Nacional de Pesquisa Clínica. CONCLUSÃO: O MS assegurou investimentos para incentivar a pesquisa clínica no Brasil, contribuindo para promover a coesão entre os investigadores, as políticas de saúde e o complexo industrial da saúde.CONTEXT AND OBJECTIVE: Scientific and technological development is crucial for advancing the Brazilian health system and for promoting quality of life. The way in which the Brazilian Ministry of Health has supported clinical research to provide autonomy, self-sufficiency, competitiveness and innovation for the healthcare industrial production complex, in accordance with the National Policy on Science, Technology and Innovation in Healthcare, was analyzed. DESIGN AND SETTING: Descriptive investigation, based on secondary data, conducted at the Department of Science and Technology, Ministry of Health. METHODS: The Ministry of Health's research management database, PesquisaSaúde, was analyzed from 2002 to 2009, using the key word "clinical research" in the fields "primary sub-agenda" or "secondary sub-agenda". The 368 projects retrieved were sorted into six categories: basic biomedical research, preclinical studies, expanded clinical research, clinical trials, infrastructure support and health technology assessment. From a structured review on "clinical research funding", results from selected countries are presented and discussed. RESULTS: The amount invested was R$ 140 million. The largest number of projects supported "basic biomedical research", while the highest amounts invested were in "clinical trials" and "infrastructure support". The southeastern region had the greatest proportion of projects and financial resources. In some respects, Brazil is ahead of other BRICS countries (Russia, India, China and South Africa), especially with regard to establishing a National Clinical Research Network. CONCLUSION: The Ministry of Health ensured investments to encourage clinical research in Brazil and contributed towards promoting cohesion between investigators, health policies and the healthcare industrial production complex

Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic: a matched analysis

Background: The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with coronavirus disease 2019 (COVID-19)-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior noninvasive respiratory support on outcomes. Methods: This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICUs) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of ICU admission. Propensity score matching was used to achieve a balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different time-point (48 h from ICU admission) for early and delayed intubation. Results: Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After propensity score matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%; p=0.01), ICU mortality (25.7% versus 36.1%; p=0.007) and 90-day mortality (30.9% versus 40.2%; p=0.02) compared with the early intubation group. Very similar findings were observed when we used a 48-h time-point for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth waves, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (HFNC) (n=294) who were intubated earlier. The subgroup of patients undergoing noninvasive ventilation (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. Conclusions: In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received HFNC

Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis