Evaluación y propuesta de organización de los servicios de salud del sistema de salud (SISAN) de la Fuerza Aérea Peruana (FAP) en Lima y Callao en el periodo 2018-2020

El objetivo de esta investigación es mejorar la situación de salud de la población sujeta de atención de la Fuerza Aérea Peruana (FAP) residente en Lima Metropolitana y la Provincia Constitucional del Callao a través de la organización de la oferta de servicios de las instituciones prestadoras de servicios de salud (IPRESS) del primer nivel de atención y el Hospital Central FAP (HOSPI). El problema principal identificado fue el tiempo de espera prolongado y las crecientes listas de espera para el acceso a los servicios de salud en el HOSPI el que se encuentra saturado debido a la atención de personal FAP y familiares que podrían acudir al primer y segundo nivel atención y no lo hacen porque se encuentran desorganizados y con una débil capacidad resolutiva. Para el diagnóstico situacional del Sistema de Salud de la FAP (SISAN) se utilizaron dos metodologías: el modelo de Kast y Rosenzweig para el análisis interno y para el análisis del entorno se usó el modelo de Collerette y Schneider; después de lo cual se identificó una realidad problemática conformada por diferentes brechas entre la situación actual y la situación esperada. Los productos propuestos para resolver la realidad problemática, incluyen: a) Implementación de una Unidad de Atención Primaria de Salud (UAPS) en Lima Metropolitana y Callao a través de una Asociación Público Privada (APP) o contrato de servicio; b) Elaboración de una Directiva FAP con la cartera de servicios de salud prestados por la UAPS; c) Elaboración de una Directiva FAP de Referencias y Contrareferencias en Lima Metropolitana y Callao; y d) Elaboración de una Ordenanza FAP que establezca el petitorio de productos farmacéuticos en el primer nivel de atención del SISAN FAP. Para el análisis de la viabilidad y factibilidad de la implementación de los productos propuestos se utilizó la metodología Sistema de Análisis de Capacidad Institucional (SADCI), mientras que la evaluación de los posibles actores que se pudieran oponer a la implementación se realizó usando el método MACTOR; luego de lo cual se encontró que los productos son viables y podrían contribuir a la solución de los problemas planteados. Por último, se realizó un análisis gerencial que permitió llegar a la conclusión que la mejor alternativa de solución del problema es la implementación de una Unidad de Atención Primaria de Salud (UAPS), bajo la forma de una Asociación Público- Privada (APP) modalidad “bata blanca” en el primer nivel de atención del SISAN FAP en Lima Metropolitana y Callao

The Helicobacter pylori Genome Project : insights into H. pylori population structure from analysis of a worldwide collection of complete genomes

Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics

Hyperspectral image processing for the identification and quantification of lentiviral particles in fluid samples

Optical spectroscopic techniques have been commonly used to detect the presence of biofilm-forming pathogens (bacteria and fungi) in the agro-food industry. Recently, near-infrared (NIR) spectroscopy revealed that it is also possible to detect the presence of viruses in animal and vegetal tissues. Here we report a platform based on visible and NIR (VNIR) hyperspectral imaging for non-contact, reagent free detection and quantification of laboratory-engineered viral particles in fluid samples (liquid droplets and dry residue) using both partial least square-discriminant analysis and artificial feed-forward neural networks. The detection was successfully achieved in preparations of phosphate buffered solution and artificial saliva, with an equivalent pixel volume of 4 nL and lowest concentration of 800 TU·μ L−1. This method constitutes an innovative approach that could be potentially used at point of care for rapid mass screening of viral infectious diseases and monitoring of the SARS-CoV-2 pandemic.This research was funded by grants number COV20-00080 and COV20-00173 of the 2020 Emergency Call for Research Projects about the SARS-CoV-2 virus and the COVID-19 disease of the Institute of Health ‘Carlos III’, Spanish Ministry of Science and Innovation, and by grant number EQC2019-006240-P of the 2019 Call for Acquisition of Scientifc Equipment, FEDER Program, Spanish Ministry of Science and Innovation. This work has been supported by the European Commission through the JRC HUMAINT project. ABR was supported by grant number RTI2018-094465-J funded by the Spanish National Agency of Research

Optical imaging spectroscopy for rapid, primary screening of SARS-CoV-2: a proof of concept

Effective testing is essential to control the coronavirus disease 2019 (COVID-19) transmission. Here we report a-proof-of-concept study on hyperspectral image analysis in the visible and near-infrared range for primary screening at the point-of-care of SARS-CoV-2. We apply spectral feature descriptors, partial least square-discriminant analysis, and artificial intelligence to extract information from optical diffuse reflectance measurements from 5 µL fluid samples at pixel, droplet, and patient levels. We discern preparations of engineered lentiviral particles pseudotyped with the spike protein of the SARS-CoV-2 from those with the G protein of the vesicular stomatitis virus in saline solution and artificial saliva. We report a quantitative analysis of 72 samples of nasopharyngeal exudate in a range of SARS-CoV-2 viral loads, and a descriptive study of another 32 fresh human saliva samples. Sensitivity for classification of exudates was 100% with peak specificity of 87.5% for discernment from PCR-negative but symptomatic cases. Proposed technology is reagent-free, fast, and scalable, and could substantially reduce the number of molecular tests currently required for COVID-19 mass screening strategies even in resource-limited settings.This research was funded by Grants Number COV20-00080 and COV20-00173 of the 2020 Emergency Call for Research Projects about the SARS-CoV-2 virus and the COVID-19 disease of the Institute of Health ‘Carlos III’, Spanish Ministry of Science and Innovation, and by Grant Number EQC2019-006240-P funded by MICIN/AEI/10.13039/501100011033 and by “ERDF A way of making Europe”. ABR was supported by Grant Number RTI2018-094465-J-I00 funded by MICIN/AEI/10.13039/501100011033 and by “ERDF A way of making Europe”. This work has been supported by the European Commission through the Joint Research Center (JRC) HUMAINT project

Optical imaging spectroscopy for rapid, primary screening of SARS-CoV-2: a proof of concept

Effective testing is essential to control the coronavirus disease 2019 (COVID-19) transmission. Here we report a-proof-of-concept study on hyperspectral image analysis in the visible and near-infrared range for primary screening at the point-of-care of SARS-CoV-2. We apply spectral feature descriptors, partial least square-discriminant analysis, and artificial intelligence to extract information from optical diffuse reflectance measurements from 5 µL fluid samples at pixel, droplet, and patient levels. We discern preparations of engineered lentiviral particles pseudotyped with the spike protein of the SARS-CoV-2 from those with the G protein of the vesicular stomatitis virus in saline solution and artificial saliva. We report a quantitative analysis of 72 samples of nasopharyngeal exudate in a range of SARS-CoV-2 viral loads, and a descriptive study of another 32 fresh human saliva samples. Sensitivity for classification of exudates was 100% with peak specificity of 87.5% for discernment from PCR-negative but symptomatic cases. Proposed technology is reagent-free, fast, and scalable, and could substantially reduce the number of molecular tests currently required for COVID-19 mass screening strategies even in resource-limited settings

Acueducto del Padre Tembleque. Patrimonio de la Humanidad

Este libro reúne las investigaciones de un grupo de académicos de la Universidad Autónoma del Estado de México, cuyo principal objetivo es poner en perspectiva la construcción de Tembleque desde diversas áreas del conocimiento. Las indagaciones del complejo hidráulico van desde el estudio arquitectónico, ecológico, ambiental, de biodiversidad, de ingeniería estructural e histórico, este último es fundamental para entender el contexto y la cultura en la cual se desarrolló, porque toda obra arquitectónica está íntimamente relacionada con su entorno. Los investigadores realizan una tarea extensa de las condiciones materiales del acueducto y las condiciones geográficas de la zona donde se encuentra y hacen énfasis en los acontecimientos históricos que sirven como punto de partida para su estudio. Este texto es producto de un esfuerzo colaborativo y multidisciplinario, encaminado a la exploración de las circunstancias que rodearon la edificación del Acueducto del Padre Tembleque

Revista Temas Agrarios Volumen 26; Suplemento 1 de 2021

1st International and 2nd National Symposium of Agronomic Sciences: The rebirth of the scientific discussion space for the Colombian Agro.1 Simposio Intenacional y 2 Nacional de Ciencias Agronómicas: El renacer del espacio de discusión científica para el Agro colombiano

Time-dependent analysis of extra length of stay and mortality due to ventilator-associated pneumonia in intensive-care units of ten limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC)

Ventilator-associated pneumonias (VAPs) are a worldwide problem that significantly increases patient morbidity, mortality, and length of stay (LoS), and their effects should be estimated to account for the timing of infection. The purpose of the study was to estimate extra LoS and mortality in an intensive-care unit (ICU) due to a VAP in a cohort of 69 248 admissions followed for 283 069 days in ICUs from 10 countries. Data were arranged according to the multi-state format. Extra LoS and increased risk of death were estimated independently in each country, and their results were combined using a random-effects meta-analysis. VAP prolonged LoS by an average of 2.03 days (95% CI 1.52-2.54 days), and increased the risk of death by 14% (95% CI 2-27). The increased risk of death due to VAP was explained by confounding with patient morbidity

XV International Congress of Control Electronics and Telecommunications: "The role of technology in times of pandemic and post-pandemic: innovation and development for strategic social and productive sectors"

La anterior selección, motivados por la aseveración de Manuel Castells -hace casi 20 años ya- que la innovación y la difusión de la tecnología parecía ser la herramienta apropiada para el desarrollo en la era de la información. Este 2020, sin embargo, ante la situación disruptiva que aquejó y aqueja a la sociedad red como una estructura social emergente de la Era de la Información basada en redes de producción, energizadas por el poder y la experiencia; falló y debe reencontrar su rumbo. Es así que los problemas acuciantes, ahora, fueron: la atención sanitaria y la superación de la epidemia de Sars Cov 2; tomó forma la, hasta entonces, visión irrealista de Castells que … no podemos avanzar con nuestros modelos de desarrollo actual, destruyendo nuestro entorno y excluyendo a la mayor parte de la humanidad de los beneficios de la revolución tecnológica más extraordinaria de la historia, sin sufrir una devastadora reacción por parte de la sociedad y la naturaleza. Fue así que el Cuarto Mundo, específicamente, donde la suficiencia de recurso humano, de capital, trabajo, información y mercado -vinculados todos a través de la tecnología- supuso que atendería eficazmente a través de la población que podía por su capacidad hacer uso racional y profesional del conocimiento, las necesidades de la mayoritaria población vulnerable y vulnerada. Por lo anterior, poner en el centro a las personas, en entornos de tarea y trabajo globales hiperconectados combinando espacios físicos, corrientes de información con canales de conexión expeditos, y formando profesionales del conocimiento que asuman y afronten los retos derivados de la transformación digital de empresas, universidades, y organizaciones, pero en condiciones de equidad y sujetos de prosperidad, será el desafío en los escenarios presentes y futuros inmediatos.The previous selection, motivated by the assertion of Manuel Castells -almost 20 years ago- that innovation and diffusion of technology seemed to be the appropriate tool for development in the information age. This 2020, however, in the face of the disruptive situation that afflicted and continues to afflict the network society as an emerging social structure of the Information Age based on production networks, energized by power and experience; He failed and must find his way again. Thus, the pressing problems now were: health care and overcoming the Sars Cov 2 epidemic; Castells' until then unrealistic vision took shape that... we cannot advance with our current development models, destroying our environment and excluding the majority of humanity from the benefits of the most extraordinary technological revolution in history, without suffering a devastating reaction from society and nature. It was thus that the Fourth World, specifically, where the sufficiency of human resources, capital, work, information and market - all linked through technology - meant that it would serve effectively through the population that could, due to its capacity, make rational use. and knowledge professional, the needs of the majority vulnerable and vulnerable population. Therefore, putting people at the center, in hyperconnected global task and work environments, combining physical spaces, information flows with expedited connection channels, and training knowledge professionals who assume and face the challenges derived from the digital transformation of companies, universities, and organizations, but in conditions of equality and subject to prosperity, will be the challenge in the present and immediate future scenarios.Bogot