15 research outputs found
Aplicaciones en Argentina
Presentamos en este capítulo un amplio abanico de campos de investigación y desarrollo en Argentina en lo referente a sistemas de predicción por conjuntos (SPC) y predicción probabilista. Desde pronósticos por ensambles basados en varias técnicas con el modelo WRF como base, pasando por la aplicación de métodos de análogos, hasta predicción estacional y, además, técnicas avanzadas de visualización específicas para predicción probabilista. Al igual que en el capítulo dedicado a México, por el enorme interés cultural de la diversidad lingüística, se ha respetado la terminología original del trabajo, de uso al otro lado del Atlántico, aclarando algún término por facilitar la consistencia con otros capítulos de este volumen. Por ejemplo, en este capítulo se usa el término ensambles, mientras que en esta obra en general usamos el acrónimo SPC o el anglicismo ensembles.Fil: Ruiz, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; Argentina. Instituto Franco-argentino sobre Estudios del Clima y sus Impactos; ArgentinaFil: Aldeco, Laura Soledad. Ministerio de Defensa. Secretaria de Planeamiento. Servicio Meteorológico Nacional; ArgentinaFil: Diehl, Alexandra. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales; Argentina. Universidad de Constanz; Alemania. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Garcia Skabar, Yanina. Instituto Franco-argentino sobre Estudios del Clima y sus Impactos; Argentina. Ministerio de Defensa. Secretaria de Planeamiento. Servicio Meteorológico Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Matsudo, Cynthia Mariana. Ministerio de Defensa. Secretaria de Planeamiento. Servicio Meteorológico Nacional; ArgentinaFil: Osman, Marisol. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; Argentina. Instituto Franco-argentino sobre Estudios del Clima y sus Impactos; ArgentinaFil: Pelorosso, Leandro. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Computación; ArgentinaFil: Saulo, Andrea Celeste. Ministerio de Defensa. Secretaria de Planeamiento. Servicio Meteorológico Nacional; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; Argentina. Instituto Franco-argentino sobre Estudios del Clima y sus Impactos; ArgentinaFil: Vera, Carolina Susana. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Centro de Investigaciones del Mar y la Atmósfera. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Centro de Investigaciones del Mar y la Atmósfera; Argentina. Instituto Franco-argentino sobre Estudios del Clima y sus Impactos; Argentin
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Modelo pedagógico de pensamiento complejo en diseño gráfico.
Los diversos modelos pedagógicos postulados en las instituciones generan inquietudes al momento de ser aplicados a las diferentes disciplinas, por tal motivo surge la inquietud de analizar los grados de coherencia que existe entre el modelo de pensamiento complejo y el proceso de enseñanza de diseño gráfico. Así mismo, el presente artículo tiene como fin dar a conocer la consolidación de los diferentes modelos pedagógicos que han influido en el proceso formativo de los diseñadores gráficos. Conclusión: La complejidad en diseño funciona en todos los aspectos de la vida y en los tres campos en los que interviene directamente (el usuario, la necesidad y el context
Enquiring beneath the surface: can a gene expression assay shed light into the heterogeneity among newborns with neonatal encephalopathy?
Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study
Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe
Implementation of a University Guidance Service (SOU) in the Faculty of Biological Sciences: Comprehensive Student Support and Monitoring Program
El acompañamiento y el seguimiento académico de los estudiantes son tareas de gran importancia, necesarias para garantizar el éxito de su carrera profesional durante su vida universitaria, y después de ésta. Estos procesos no comienzan necesariamente con el ingreso de los estudiantes en la Universidad, sino que se extienden a los estudiantes de último curso de educación secundaria y bachillerato. Existe por tanto la necesidad de incluir dentro de las acciones que realizamos en la facultad (información, formación, inclusión) a los estudiantes de bachillerato, dándoles a conocer nuestro entorno de cara a su incorporación en la facultad. Por otro lado, la experiencia del equipo que trabajará en este proyecto, nos ha llevado a ser conscientes de los innumerables problemas que tienen los estudiantes de nuestra facultad para obtener información, formación, acompañamiento, seguimiento o inclusión en cuestiones que pueden afectar de una forma directa en sus actividades académica cotidianas y en su formación integral que reciben en nuestra facultad. La falta de una unidad o servicio centralizado para satisfacer estas necesidades ha sido aún más patente desde la pandemia. En la Facultad de Ciencias Biológicas se realizan multitud de actividades relacionadas con estas iniciativas y que son desconocidas por gran parte de la comunidad universitaria. Las acciones que se vienen realizando desde la facultad de Ciencias Biológicas estas dispersas entre distintos servicios y vicedecanatos (Vicedecanato de Calidad, Innovación y Sostenibilidad, Vicedecanato de Estudiantes, Practicas Externas y Movilidad, Vicedecanato de Estudios, Coordinadora de Grado, Oficina Erasmus, Vicedecanato de Investigación, Secretaría Académica, Delegación de Estudiantes, Oficina de Diversidad, etc.). En este sentido, con este proyecto pretendemos potenciar, sincronizar, coordinar y dar visibilidad a todas estas, mostrando la inmensa utilidad que suponen para nuestros estudiantes, cómo influyen en la mejora de sus actividades académicas curriculares y extracurriculares y su proyección hacia el mundo laboral. Analizaremos cómo cada una de estas actividades influyen positivamente generando una retroalimentación entre los distintos grupos de participantes del proyecto: Estudiantes, Profesores y Personal de Administración y Servicios. Todo ello, será evaluado cualitativa y cuantitativamente mediante la elaboración de encuestas a cada uno de los sectores y los comentarios y evaluaciones que el programa Docentia nos pueda aportar. La finalidad, por tanto, de este proyecto es crear de forma integrativa un Servicio de Orientación Universitario (SOU) para los estudiantes de nuestra facultad, donde se engloben todas las actividades de acompañamiento y seguimiento que venimos realizando, junto con otras que puedan surgir. Todo ello permitirá mejorar la integración y el desenvolvimiento de nuestros estudiantes en el centro mediante su participación en distintas acciones que, a su vez, redundarán en un mejor aprovechamiento de los recursos del centro, una mejora curricular y, en último término, facilitarán su proyección laboral. Este proyecto, también tiene por objetivo solventar la necesidad existente de dar visibilidad a las actividades de acompañamiento y seguimiento de estudiantes que los distintos colectivos de la facultad realizan, con la finalidad de mejorar su aprovechamiento y su optimización a través un análisis de fortalezas y debilidades, lo que nos permitirá generar futuras nuevas acciones que se integrarán en el SOU de la Facultad de Ciencias Biológicas.UCMDecanatoDepto. de Genética, Fisiología y MicrobiologíaFac. de Ciencias BiológicasFALSEsubmitte