Sistema político y movimientos indígenas: el caso del EZLN

El presente artículo analiza la vinculación del EZLN con la situación miserable en que se encuentran millones de indígenas en México contra la ingobernabilidad neoliberal. Presentamos posibles soluciones al conflicto EZLN, y resumimos los logros alcanzados por los grupos étnicos en materia de democracia dentro del Estado mexicano

Static range of motion of the first metatarsal in the sagittal and frontal planes

The first metatarsal and medial cuneiform form an important functional unit in the foot, called “first ray”. The first ray normal range of motion (ROM) is difficult to quantify due to the number of joints that are involved. Several methods have previously been proposed. Controversy exists related to normal movement of the first ray frontal plane accompanying that in the sagittal plane. The objective of this study was to investigate the ROM of the first ray in the sagittal and frontal planes in normal feet. Anterior-posterior radiographs were done of the feet of 40 healthy participants with the first ray in a neutral position, maximally dorsiflexed and maximally plantarflexed. They were digitalized and the distance between the tibial malleolus and the intersesamoid crest in the three positions mentioned was measured. The rotation of the first ray in these three positions was measured. A polynomic function that fits a curve describing the movement observed in the first ray was obtained using the least squares method. ROM of the first ray in the sagittal plane was 6.47 (SD 2.59) mm of dorsiflexion and 6.12 (SD 2.55) mm of plantarflexion. ROM in the frontal plane was 2.69 (SD 4.03) degrees of inversion during the dorsiflexion and 2.97 (SD 2.72) degrees during the plantarflexion. A second-degree equation was obtained, which represents the movement of the first ray. Passive dorsiflexion and plantarflexion of the first ray were accompanied by movements in the frontal plane: 0.45 degrees of movement were produced in the frontal plane for each millimeter of displacement in the sagittal plane. These findings might be useful for the future design of instruments for clinically quantifying first ray mobility

La construcción sostenible de viviendas en Quito: 2015-2019 Valle de Los Chillos.

La presente investigación analiza la creciente demanda de unidades de vivienda a gran escala y como está afectando al medio ambiente por el aumento en el consumo de energía y la generación de desechos. Los resultados del análisis sugieren revisar y actualizar los documentos emitidos que regulan la construcción en el gobierno central y los GAD´S.This research analyzes the growing demand for large-scale housing units and its impact on the environment through increased energy consumption and waste generation. It examines whether housing project designs include environmental impact assessments and ways to mitigate such impact

NIVEL DE CONOCIMIENTO DE LA INFLUENZA TIPO A (H1N1) EN LOS MÉDICOS DE LOS CENTROS DE SALUD DE LAS MICROREDES CONO NORTE Y CONO SUR DEL MINISTERIO DE SALUD TACNA

La influenza tipo A (H1N1) es causada por un virus que se transmite de humano a humano, tiene una gran variabilidad clínica, desde casos asintomáticos hasta graves y fatales. En nuestra situación actual que estamos viviendo epidemiológicamente, necesitamos contar con profesionales médicos debidamente capacitados para actuar en forma eficaz con posibles casos de infección en nuestra localidad; por tal motivo se evaluó a los médicos de las micro redes de cono norte y de cono sur durante el periodo del mes de mayo del 2009, para determinar el nivel de conocimiento que poseen estos mismos de la influenza tipo A (H1N1). La muestra encuestada exitosamente corresponde al 88,89% de la población total de médicos. Se utilizo un instrumento tipo cuestionario para el cuerpo médico, constituido por 14 preguntas que evaluaron el conocimiento de la influenza tipo A (H1N1). La confiabilidad del instrumento se midió por el método de Kuder Richardson. Para la evaluación del cuestionario se usó una escala de rango de notas y su equivalencia cualitativa, desde excelente hasta deficiente. Los resultados obtenidos revelaron que 12,5% de los médicos encuestados tuvieron un nivel bueno de conocimientos sobre la influenza A (HIN I), pero el 84,4% y el 3,1% de estos profesionales tuvo un nivel regular y deficiente respectivamente. Los temas respecto a la influenza A (HINI) de mayor desinformación en los médicos son el tratamiento farmacológico y con toque mejor capacitado se encontraron, fueron las medidas generales y preventivas para el control de la transmisión del virus de la influenza A (H1N1)

Bipartite hallucal sesamoid bones: relationship with hallux valgus and metatarsal index

Objective. To relate the incidence of the partition of the hallucal sesamoid bones with the size of the first metatarsal and the hallux valgus deformity. Materials and Methods. In a sample of 474 radiographs, the frequency of appearance of bipartite sesamoids was studied. The length and relative protrusion of the first metatarsal, and the hallux abductus angle, were measured and compared between the feet with and without sesamoid partition. Results. The results showed that 14.6% of the feet studied had at least one partite sesamoid, that the sesamoid most frequently divided was the medial, and that unilateral partition was the most common. No difference was found in the incidence of partite sesamoids between men and women, or between left and right feet. Conclusion. Protrusion and length of the first metatarsal are higher in feet with partite sesamoids than in feet without this condition. A significantly higher incidence of bipartite medial sesamoid was obtained in feet with hallux valgus compared with normal feet

Switching from reference infliximab to CT-P13 in patients with inflammatory bowel disease: 12 months results

Background: Biological agents, such as infliximab, have transformed the outcomes of patients with immune-mediated inflammatory diseases. The advent of biosimilar treatment options such as CT-P13 promises to improve the availability of biological therapy, yet real-world switching data are currently limited. Here, we assess the effectiveness and safety of switching to CT-P13 from infliximab reference product (RP) in patients with inflammatory bowel disease. Materials and methods: This was a prospective single-center observational study in patients with moderate to severe Crohn’s disease (CD) and ulcerative colitis (UC). All patients were switched from infliximab RP (Remicade) to CT-P13 treatment and followed up for up to 12 months. The efficacy endpoint was the change in clinical response assessed at 3-monthly intervals, according to the Harvey–Bradshaw score and partial Mayo score for patients with CD and UC, respectively. C-reactive protein (CRP) was also measured. Adverse events were monitored and recorded throughout the study. Results: A total of 98 patients with inflammatory bowel disease (67 CD/31 UC) were included. A total of 83.6% (56/67) of patients with CD were in remission at the time of the switch and 62.7% were in remission at 12 months. The Harvey–Bradshaw score showed a significant change at 12 months (P =0.007) but no significant change was observed in median CRP at this timepoint (P= 0.364). A total of 80.6% (25/31) of patients with UC were in remission at the time of the switch and 65.3% (18/28) were in remission at 12 months. No significant changes in the median partial Mayo score (P=0.058) or CRP (P =0.329) were observed at 12 months. Serious adverse events related to medication were reported in 11 (11.2%) patients. Conclusion: Switching from infliximab RP to CT-P13 is efficacious and well tolerated in patients with CD or UC for up to 12 months

Adaptation and validation of the spanish version of the instrument to Evaluate nurses’ attitudes toward communication with the patient for nursing students

Communication is essential to the quality of care and patient satisfaction. It has been linked to positive patient outcomes, increased engagement, improved health outcomes, and safe practices. Given these benefits and the association between attitudes and behaviors, as behaviors can be predicted by studying attitudes, assessing attitudes of nursing students toward patient communication is critical for future nursing professionals. For this purpose, the main aim of this study was to adapt and validate an instrument to measure nurses’ attitudes toward communication (ACO) for nursing students. The ACO with patients was analyzed. Then, differences in the dimensions of the instrument (ACO) for nursing students according to an academic course and the correlations were calculated. A cross-sectional study was carried out in a convenience sample of 1,417 nursing students from five universities in the Valencian Community (Spain) during the 2018/2019 academic year and 83.8% (1,187) were women. The reliability was analyzed by using Cronbach’s alpha and composite reliability (CR). Analysis of construct validity was performed with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The instrument adapted from nurses to nursing students was composed of 25 items grouped in three dimensions: affective, cognitive, and behavioral. The psychometric properties suggested that the instrument ACO for nursing students was reliable and valid. The ACO of nursing students was positive with high levels in cognitive and behavioral dimensions, while scores were worst in the affective component. The second-year nursing students showed more positive attitudes in the affective dimension, while in the cognitive and behavioral dimensions, the most positive attitudes were found in the first year. In the correlations, the behavioral and cognitive dimensions showed a significant, positive, and very high correlation. These findings should be considered in developing academic plans to improve the effectiveness of the communication education process of the students to increase the quality of patient care and well-being of nursing students

Medial deviation of the first metatarsal in incipient hallux valgus deformity

The intermetatarsal angle between metatarsals I and II (IMA 1-2) has been radiographicaly studied in 49 normal feet and in 49 feet with a mild hallux valgus (HV) deformity. The aim of the study is to know whether an excessive medial deviation of the first metatarsal with respect to II (IMA 1-2 over normal values reported by some authors) is present in the initial phase of HV. The results demonstrate that the difference in the mean intermetatarsal angle between the two groups is statistically significant (8.76º in normal feet; 9.98º in affected feet). However, the authors think it is not clinically significant. Other authors, comparing the IMA 1-2 in patients with more advanced HV and without HV, report greater differences than those obtained in this study,. The authors conclude that the excessive medial deviation of the first metatarsal is not a causal factor, but a consequence, in the HV deformity

Impacts of the exhaust gas recirculation (EGR) combined with the regeneration mode in a compression ignition diesel engine operating at cold conditions

This is the author's version of a work that was accepted for publication in International Journal of Engine Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published as https://doi.org/10.1177/14680874211013986[EN] Internal combustion engines working at cold conditions lead to the production of excessive pollutant emissions levels. The use of the exhaust gas recirculation could be necessary to reduce the nitrogen oxides emissions, even at these conditions. This paper evaluates the impact of using the high-pressure exhaust gas recirculation strategy while the diesel particulate filter is under active regeneration mode on a Euro 6 turbocharged diesel engine running at low ambient temperature (-7 degrees C). This strategy is evaluated under 40 h of operation, 20 of them using the two systems in combination. The results show that the activation of the high-pressure exhaust gas recirculation during the particulate filter regeneration process leads to a 50% nitrogen oxides emissions reduction with respect to a reference case without exhaust gas recirculation. Moreover, the modification of some engine parameters compared to the base calibration, as the exhaust gas recirculation rate, the main fuel injection timing and the post injection quantity, allows to optimize this strategy by reducing the carbon monoxide emissions up to 60%. Regarding the hydrocarbons emissions and fuel consumption, a small advantage could be observed using this strategy. However, the activation of the high-pressure exhaust gas recirculation at low temperatures can produce fouling deposits and condensation on the engine components (valve, cooler, intake manifold, etc.) and can contribute to reach saturation conditions on the particulate filter. For these reasons, the regeneration efficiency is followed during the experiments through the filter status, concluding that the use of low high-pressure exhaust gas recirculation rates in combination with the regeneration mode also allows to clean the soot particles of the particulate filter. These soot depositions are visualized and presented at the end of this work with a brief analysis of the soot characteristics and a quantitative estimation of the total soot volume produced during the experimental campaign.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Authors want to acknowledge the support of "Programa de Ayudas de Investigacion y Desarrollo (PAID-01-17) de la Universitat Politecnica de Valencia.''Galindo, J.; Dolz, V.; Monsalve-Serrano, J.; Bernal-Maldonado, MA.; Odillard, L. (2021). Impacts of the exhaust gas recirculation (EGR) combined with the regeneration mode in a compression ignition diesel engine operating at cold conditions. International Journal of Engine Research. 22(12):3548-3557. https://doi.org/10.1177/14680874211013986S35483557221

EGR cylinder deactivation strategy to accelerate the warm-up and restart processes in a Diesel engine operating at cold conditions

This is the author's version of a work that was accepted for publication in International Journal of Engine Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published as https://doi.org/10.1177/14680874211039587[EN] The aftertreatment systems used in internal combustion engines need high temperatures for reaching its maximum efficiency. By this reason, during the engine cold start period or engine restart operation, excessive pollutant emissions levels are emitted to the atmosphere. This paper evaluates the impact of using a new cylinder deactivation strategy on a Euro 6 turbocharged diesel engine running under cold conditions (-7 degrees C) with the aim of improving the engine warm-up process. This strategy is evaluated in two parts. First, an experimental study is performed at 20 degrees C to analyze the effect of the cylinder deactivation strategy at steady-state and during an engine cold start at 1500 rpm and constant load. In particular, the pumping losses, pollutant emissions levels and engine thermal efficiency are analyzed. In the second part, the engine behavior is analyzed at steady-state and transient conditions under very low ambient temperatures (-7 degrees C). In these conditions, the results show an increase of the exhaust temperatures of around 100 degrees C, which allows to reduce the diesel oxidation catalyst light-off by 250 s besides of reducing the engine warm-up process in approximately 120 s. This allows to reduce the CO and HC emissions by 70% and 50%, respectively, at the end of the test.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Authors want to acknowledge the support of "Programa de Ayudas de Investigacion y Desarrollo (PAID-01-17) de la Universitat Politecnica de Valencia''.Galindo, J.; Dolz, V.; Monsalve-Serrano, J.; Bernal-Maldonado, MA.; Odillard, L. (2022). EGR cylinder deactivation strategy to accelerate the warm-up and restart processes in a Diesel engine operating at cold conditions. International Journal of Engine Research. 23(4):614-623. https://doi.org/10.1177/1468087421103958761462323