Propuesta de diseño de un mini acueducto por bombeo eléctrico (MABE) para la comarca Jicarito del municipio de Santo Tomas –Chontales, periodo 2015-2034

El presente trabajo de graduación describe en forma detallada el procedimiento a través del cual se desarrolló la propuesta de diseño de un mini acueducto por bombeo eléctrico para la comarca Jicarito del municipio Santo Tomas, departamento de Chontales, para un periodo de 20 años (2015-2034); con el propósito de ayudar al mejoramiento de las condiciones higiénico-sanitarias de la comunidad. El sistema fue diseñado a partir de las normas rurales para el abastecimiento de agua potable establecidas por el INAA, en combinación con los estatutos establecidos por el FISE para la formulación y desarrollo de proyectos de agua potable en el sub sector rural, considerando las condiciones particulares que rigen esta propuesta a través de un análisis a fondo de las características socioeconómicas de la comunidad, y características topográficas e hidrológicas del área en cuestión. Se realizó la valoración del impacto ambiental generado por el proyecto durante las etapas de construcción y uncionamiento, con el objetivo de determinar las medidas de mitigación necesarias. El documento también contiene la memoria de diseño y demás aspectos considerados durante las etapas de estudio y diseño, además de los datos recolectados durante la investigación de campo e información suministrada por entes competentes

La implicación del estudiantado en la resolución de conflictos sobre nuestro patrimonio cultural dentro y fuera del aula: investigar, conocer in situ, documentar y difundir.

El proyecto Patrimonio Herido plantea dos objetivos principales: fomentar el interés por la recuperación de bienes culturales en situación de peligro y reivindicar el rol del historiador del arte como profesional esencial en equipos transdisciplinares. Sus actividades formativas se desarrollan dentro y fuera del aula, destacando el conocimiento del patrimonio cultural de proximidad in situ, lo que genera vínculos significativos entre el estudiantado y los bienes que este selecciona para su estudio. Entre los resultados se solicita: realizar una ficha diagnóstico con los datos esenciales del bien; analizar los valores patrimoniales; describir su situación ante el peligro detectado; aportar soluciones coherentes transitivas, para detener los daños, y definitivas, para eliminarlos; aportar imágenes históricas, actuales y de futura propuesta. Cada año se exponen los resultados en el Encuentro Interuniversitario de Estudiantes (2024: III edición) donde, además, se desarrollan competencias y habilidades comunicativas y se participa en debates de manera crítica y razonada. Para el trabajo se plantean tres opciones: investigar un bien individual, bien siguiendo el modelo tradicional de ficha diagnóstico, o bien realizando un vídeo de TikTok donde se incluyan los resultados de la investigación; planificar un itinerario cultural a partir de elementos con daños comunes; o crear un juego tras la realización de un glosario de términos, conceptos o situaciones específicos aprendidos durante el curso. En todos los casos se integran las humanidades digitales y las TIC, demostrando que la disciplina de Historia del Arte cumple un papel fundamental para la sociedad, a quien se le da a conocer este trabajo mediante eventos de divulgación, tales como la Noche Europea de los Investigadores. Finalmente, cabe destacar que la recuperación y puesta en valor del patrimonio cotidiano genera beneficios en el ámbito local y su territorio, permitiendo la aplicación de diversos ODS.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Relación entre el Índice de Masa Corporal Materno y de sus Hijos en cuatro Sistemas Educativos de Hidalgo, México

Introduction: While the prevalence of overweight and obesity is pervasive in adults and children in Mexico, differences and relationships among children and their mothers from different ethnic groups, educational systems, and environmental settings in Mexico is understudied. Objective: The present study tested the relationship between Maternal Body Mass Index (MBMI) and Children’s Z-score Body Mass Index for Age (ZBFA) from indigenous, private, public and CONAFE (community schools in marginalized rural areas) schools representing four distinct educational systems in Hidalgo, Mexico.Material and methods: A survey-type study was carried out in a random sample of school children and their mothers. The weight and height of the children and their mothers was evaluated with standardize anthropometric techniques. Mothers’ and children’s scores were evaluated following the recommendations by the World Health Organization (WHO).Results: Prevalence of overweight was very high in mothers (55.8%), without significant differences in MBMI across the four different educational systems. Children from private schools showed higher Body Mass Index, being the girls with the highest scores. Our initial model only included MBMI and Children’s ZBFA, this relationship provided us with a model that explained only 7% of the variance. However, when school type was added as covariate in models for boys and girls, the explained variance increased (17% and 33% respectively).Conclusions: It was found evidence of a low relationship between Maternal Body Mass Index and Child Body Mass Index. This relationship was stronger when the type of school was added as a covariate. The evidence revealed differences between the environment of rural and urban schools, between mestizo populations and indigenous groups.Introducción: Si bien la prevalencia del sobrepeso y la obesidad es una epidemia en adultos y niños en México, las diferencias y las relaciones entre los niños y sus madres de diferentes grupos étnicos y sistemas educativos en México han sido poco estudiadas. Objetivo: El presente estudio probó la relación entre el Índice de Masa Corporal Materno (IMCM) y los puntajes Z del Índice de Masa Corporal de sus hijos (ZIMC) de estudiantes de escuelas indígenas, privadas, públicas y CONAFE (escuelas comunitarias rurales marginadas) en el estado de Hidalgo, México. Material y Métodos: Se realizó un estudio tipo encuesta en una muestra aleatoria de niños en edad escolar y sus madres. El peso y estatura de niños y sus madres se evaluaron con técnicas antropométricas estandarizadas de acuerdo con protocolos de la Organización Mundial de la Salud (OMS).Resultados: La prevalencia de sobrepeso fue muy alta en las madres (55,8%), sin una diferencia significativa en el IMCM por tipo de escuela. Niños que asistían a escuelas privadas tenían un ZIMC más alto, y fue mayor en el caso de las niñas. El IMCM se relacionó con el ZIMC de los niños (7% varianza explicada), cuando agregamos el tipo de escuela como covariable en modelos por sexo, el porcentaje aumentó (17% para niños y 33% para niñas).Conclusiones: Se encontró evidencia de una baja relación entre el índice de masa corporal materno y el índice de masa corporal infantil. Esta relación fue más fuerte cuando se agregó el tipo de escuela como covariable, lo que reveló diferencias entre el ambiente de las escuelas rurales y urbanas, entre las poblaciones mestizas y los grupos indígenas

Complejidad en el paciente frágil joven: dificultad para la asistencia y la atención

A 63-year-old patient with multiple myeloma with chronic renal failure and myasthenia gravis who has acute respiratory infection. Unfavorable evolution is observed by associating with acute hepatitis of drug origin. After a comprehensive assessment of the patient, the finding of possible fronto-temporal dementia is previously masked as a depressive disorder. The use of drugs in this patient implies relevant conditioning, so a therapeutic reconciliation must be carried out to avoid complications related to comorbidities.Paciente de 63 años con mieloma múltiple, insuficiencia renal crónica y miastenia gravis que presentaba infección respiratoria aguda. Se objetivó la evolución desfavorable, asociándose con hepatitis aguda de origen medicamentoso. Tras valoración integral del paciente, se llegó al hallazgo de posible demencia frontotemporal, enmascarada de forma previa como trastorno depresivo. La utilización de fármacos en esta paciente implica condicionamientos relevantes, por lo que se debe realizar una conciliación para evitar complicacio- nes relacionadas con las comorbilidades

Paleoclimatic reconstruction during the Little Ice Age in the Llanganuco basin, Cordillera Blanca (Peru)

The Equilibrium Line Altitude (ELA, m) is a good indicator for the impact of climate change on tropical glaciers , because it varies in time and space depending on changes in temperature and/or precipitation.The estimation of the ELA and paleoELA using the Area x Altitude Balance Ratio method (AABR; Osmaston, 2005) requires knowing the surface and hypsometry of glaciers or paleoglaciers (Benn et al. 2005) and the Balance Ratio (BR) correct (Rea, 2009). In the Llanganuco basin (~ 9°3´S; 77°37´W) there are very well preserved moraines near the current glaciers front. These deposits provide information to reconstruct the extent of paleoglaciers since the Little Ice Age (LIA) and deduce some paleo-climatic variables. The goal of this work has been to reconstruct the paleotemperature (°C) during LIA, deduced from the difference between ELA AABR2016 and paleoELA AABRLIA. The paleoclimatic reconstruction was carried out in 6 phases: Phase 1) Development of a detailed geomorphological map (scale 1/10,000), in order to identify glacial landforms (advance moraines and polished rocks) which, due to their geomorphological context, can be considered of LIA, so palaeoglaciers can be delimited. Current glacial extension was done using dry season, high resolution satellite images. Phase 2) Glacial bedrock Reconstruction from glacier surface following the GLABTOP methodology (Linsbauer et al 2009). Phase 3) 3D reconstruction of paleoglacial surface using GLARE tool, based on bed topography and flow lines for each defined paleoglacial (Pellitero et al., 2016). As perfect plasticity model does not reflect the tension generated by the side walls of the valley, form factors were calculated based on the glacier thickness, lateral moraines and the geometry of the valley following the equation proposed by Nye (1952), adjusting the thicknesses generated in the paleoglacial front. Phase 4) Calculation of BR in a reference glacier (Artesonraju; 8° 56’S; 77º38’W), near to the study area, using the product BR = b • z • s, where BR= Balance Ratio; b= mass balance measured in fieldwork 2004-2014 (m); z= average altitude (meters) and s= surface (m2) of each altitude band of the glacier (with intervals of 100 m altitude). A value BR = 2.3 was estimated. Phase 5) Automatic reconstruction of the ELA AABR2016 and paleoELA AABRLIA using ELA Calculation tool (Pellitero et al. 2015) after 3D reconstruction of the glacial and paleoglacial surface in phases 2 and 3. Phase 6) Estimation of paleotemperature during LIA by solving the equation of Porter et al. (1995): ∆T (°C)= ∆ELA • ATLR, where ∆T= air temperature depression (ºC); ∆ELA = variation of ELA AABR 2016-LIA and ATLR = Air Temperature Lapse Rate, using the average global value of the Earth (0.0065 °C/m), considered valid for tropics. The results obtained were: ELA AABR2016= 5260m, paleoELA AABRLIA= 5084m, and ∆T = 1.1 °C. The reconstruction of air paleotemperature is consistent with different studies that have estimated values between 1–2 °C colder than the present, with intense rainfall (Matthews & Briffa, 2005; Malone et al., 2015)

Revisiting the epidemiology of bloodstream infections and healthcare-associated episodes: results from a multicentre prospective cohort in Spain (PRO-BAC Study)

PROBAC REIPI/GEIH-SEIMC/SAEI Group.The epidemiology of bloodstream infections (BSIs) is dynamic as it depends on microbiological, host and healthcare system factors. The aim of this study was to update the information regarding the epidemiology of BSIs in Spain considering the type of acquisition. An observational, prospective cohort study in 26 Spanish hospitals from October 2016 through March 2017 including all episodes of BSI in adults was performed. Bivariate analyses stratified by type of acquisition were performed. Multivariate analyses were performed by logistic regression. Overall, 6345 BSI episodes were included; 2510 (39.8%) were community-acquired (CA), 1661 (26.3%) were healthcare-associated (HCA) and 2056 (32.6%) hospital-acquired (HA). The 30-day mortality rates were 11.6%, 19.5% and 22.0%, respectively. The median age of patients was 71 years (interquartile range 60–81 years) and 3656 (58.3%; 95% confidence interval 57.1–59.6%) occurred in males. The proportions according to patient sex varied according to age strata. Escherichia coli (43.8%), Klebsiella spp. (8.9%), Staphylococcus aureus (8.9%) and coagulase-negative staphylococci (7.4%) were the most frequent pathogens. Multivariate analyses confirmed important differences between CA and HCA episodes, but also between HCA and HA episodes, in demographics, underlying conditions and aetiology. In conclusion, we have updated the epidemiological information regarding patients’ profiles, underlying conditions, frequency of acquisition types and aetiological agents of BSI in Spain. HCA is confirmed as a distinct type of acquisition.This work was financed by grants from Plan Nacional de I+D+i 2013–2016, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades [PI16/01432] and the Spanish Network for Research in Infectious Diseases (REIPI) [RD16/0016/0001; RD16/0016/0008], co‐financed by the European Development Regional Fund ‘A way to achieve Europe’, Operative program Intelligent Growth 2014–2020

Risk Factors and Predictive Score for Bacteremic Biliary Tract Infections Due to Enterococcus faecalis and Enterococcus faecium: a Multicenter Cohort Study from the PROBAC Project

Biliary-tract bloodstream infections (BT-BSI) caused by Enterococcus faecalis and E. faecium are associated with inappropriate empirical treatment and worse outcomes compared to other etiologies. The objective of this study was to investigate the risk factors for enterococcal BT-BSI. Patients with BT-BSI from the PROBAC cohort, including consecutive patients with BSI in 26 Spanish hospitals between October 2016 and March 2017, were selected; episodes caused by E. faecalis or E. faecium and other causes were compared. Independent predictors for enterococci were identified by logistic regression, and a predictive score was developed. Eight hundred fifty episodes of BT-BSI were included; 73 (8.5%) were due to target Enterococcus spp. (48 [66%] were E. faecium and 25 [34%] E. faecalis). By multivariate analysis, the variables independently associated with Enterococcus spp. were (OR; 95% confidence interval): cholangiocarcinoma (4.48;1.32 to 15.25), hospital acquisition (3.58;2.11 to 6.07), use of carbapenems in the previous month (3.35;1.45 to 7.78), biliary prosthesis (2.19;1.24 to 3.90), and moderate or severe chronic kidney disease (1.55;1.07 to 2.26). The AUC of the model was 0.74 [95% CI0.67 to 0.80]. A score was developed, with 7, 6, 5, 4, and 2 points for these variables, respectively, with a negative predictive value of 95% for a score # 6. A model, including cholangiocarcinoma, biliary prosthesis, hospital acquisition, previous carbapenems, and chronic kidney disease showed moderate prediction ability for enterococcal BT-BSI. Although the score will need to be validated, this information may be useful for deciding empirical therapy in biliary tract infections when bacteremia is suspected. IMPORTANCE Biliary tract infections are frequent, and a significant cause of morbidity and mortality. Bacteremia is common in these infections, particularly in the elderly and patients with cancer. Inappropriate empirical treatment has been associated with increased risk of mortality in bacteremic cholangitis, and the probability of receiving inactive empirical treatment is higher in episodes caused by enterococci. This is because many of the antimicrobial agents recommended in guidelines for biliary tract infections lack activity against these organisms. To the best of our knowledge, this is the first study analyzing the predictive factors for enterococcal BT-BSI and deriving a predictive score.8 página

COVID-19 outbreaks in a transmission control scenario: challenges posed by social and leisure activities, and for workers in vulnerable conditions, Spain, early summer 2020

Severe acute respiratory syndrome coronavirus 2 community-wide transmission declined in Spain by early May 2020, being replaced by outbreaks and sporadic cases. From mid-June to 2 August, excluding single household outbreaks, 673 outbreaks were notified nationally, 551 active (>6,200 cases) at the time. More than half of these outbreaks and cases coincided with: (i) social (family/friends’ gatherings or leisure venues) and (ii) occupational (mainly involving workers in vulnerable conditions) settings. Control measures were accordingly applied

Influence of the Temperature and the Genotype of the HSP90AA1 Gene over Sperm Chromatin Stability in Manchega Rams

The present study addresses the effect of heat stress on males' reproduction ability. For that, we have evaluated the sperm DNA fragmentation (DFI) by SCSA of ejaculates incubated at 37°C during 0, 24 and 48 hours after its collection, as a way to mimic the temperature circumstances to which spermatozoa will be subject to in the ewe uterus. The effects of temperature and temperature-humidity index (THI) from day 60 prior collection to the date of semen collection on DFI were examined. To better understand the causes determining the sensitivity of spermatozoa to heat, this study was conducted in 60 males with alternative genotypes for the SNP G/C−660 of the HSP90AA1 promoter, which encode for the Hsp90α protein. The Hsp90α protein predominates in the brain and testis, and its role in spermatogenesis has been described in several species. Ridge regression analyses showed that days 29 to 35 and 7 to 14 before sperm collection (bsc) were the most critical regarding the effect of heat stress over DFI values. Mixed model analyses revealed that DFI increases over a threshold of 30°C for maximum temperature and 22 for THI at days 29 to 35 and 7 to 14 bsc only in animals carrying the GG−660 genotype. The period 29–35 bsc coincide with the meiosis I process for which the effect of the Hsp90α has been described in mice. The period 7–14 bsc may correspond with later stages of the meiosis II and early stages of epididymal maturation in which the replacement of histones by protamines occurs. Because of GG−660 genotype has been associated to lower levels of HSP90AA1 expression, suboptimal amounts of HSP90AA1 mRNA in GG−660 animals under heat stress conditions make spermatozoa DNA more susceptible to be fragmented. Thus, selecting against the GG−660 genotype could decrease the DNA fragmentation and spermatozoa thermal susceptibility in the heat season, and its putative subsequent fertility gainsPublishe

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality