Diseño de tramo carretera la Argentina- La Azucena Aplicando un Sistema de diseño asistido por Computadora

Presenta el diseño de 8.6 kilómetros de carretera denominado La Argentina La Azucena, el cual se encuentra en el municipio de San Carlos, departamento de Río San Juan, Nicaragua, iniciando en la estación 0+000 y finalizando en la estación 8+620, carretera NIC-25

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies

Diagnóstico para la implementación del Sistema de Gestión de la Calidad para el proceso de Investigación en la Facultad de Ciencias Químicas, tomando como guía la norma ISO 9001-2015 período enero 2018 - junio 2021

Tesis (MSc. en Aseguramiento de la Calidad en la Industria Farmacéutica, Alimentaria, Cosmética, Veterinaria y afines)-Universidad Nacional Autónoma de Nicaragua, LeónUNAN-Leó

Factors Associated With Early Functional Outcome After Hip Fracture Surgery

Background: Hip fractures are common in the elderly and are likely to become more prevalent as the US population ages. Early functional status is an indicator of longer term outcome, yet in-hospital predictors of functional recovery, particularly time of surgery and composition of support staff, after hip fracture surgery have not been well studied. Methods: Ninety-nine consecutive patients underwent hip fracture surgery by a single surgeon between 2009 and 2013. Surgery after 48 hours was deemed as surgical delay, and surgery after 5 pm was deemed as after hours. Surgical support staff experience was determined by experts from our institution as well as documented level of training. Functional status was determined by independent ambulation on postoperative day (POD) 3. Results: On POD3, 48 (79%) of 62 patients with no delay were able to ambulate, whereas only 14 (38%) of 37 patients with delayed surgery were able to ambulate ( P < .001). This relationship persisted when adjusted for American Society of Anesthesiologist classification. No delay in patients older than 80 (odds ratio [OR], 6.91; 95% confidence interval [CI], 2.16-22.10) and females (OR, 7.05; 95% CI, 2.34-21.20) was associated with greater chance of early ambulation. After-hours surgery was not associated with ambulation ( P = .35). Anesthesiologist and circulating nurse experience had no impact on patient’s ambulatory status; however, nonorthopedic scrub technicians were associated with worse functional status (OR 7.50; 95% CI, 1.46-38.44, P = .01). Conclusion: Surgical delay and nonorthopedic scrub technicians are associated with worse early functional outcome after hip fracture surgery. Surgical delay should be avoided in older patients and women. More work should be done to understand the impact of surgical team composition on outcome