Estudio de factibilidad para la implementación de soluciones energéticas individuales mediante paneles solares para la zona rural de la región Montes de María en el departamento de Sucre

En su devenir histórico y buscando mejorar sus condiciones de vida, las necesidades energéticas del ser humano han evolucionado constantemente. El consumo de energía ha experimentado a través de la historia un crecimiento continuo en paralelo con el desarrollo de la tecnología, los hábitos de vida y las formas de organización social. Existe un abismo entre las demandas energéticas de las comunidades apartadas cuya necesidad energética básica es la alimentación, y los ciudadanos de los centros poblados que requieren la energía eléctrica para realizar sus actividades cotidianas (Medellín, 2011)

Fuentes, síntomas y estrategias de afrontamiento al estrés-competitivo en nadadores

La presente investigación de tipo descriptivo transversal tuvo como objetivo caracterizar el estrés precompetitivo de 123 nadadores mexicanos de categoría master. La edad de los participantes osciló entre los 36 y 92 años de edad. El instrumento utilizado para recoger la información fue el cuestionario FUSIES (fuentes, síntomas y estrategias de afrontamiento al estrés), este se aplicó antes de iniciar una competencia nacional perteneciente al serial master de natación. El instrumento midió la percepción del estrés, bajo una escala tipo Likert de 1= nunca y 5 = extremo, con alfa de Cronbach de .95. Entre los principales resultados se observó un nivel normal bajo de estrés (M = 2.307 ± .5) en los nadadores; las fuentes que generan mayor estrés son la injusticia de autoridades (M = 3.70 ± 1.2), mucho tráfico (M = 3.48 ± 1.1) y no tener dinero (M = 3.28 ± 1.2). A su vez, los síntomas de estrés con mayor puntaje en los nadadores es la preocupación (M = 2.96 ± 1.08), la tensión en la espalda (M = 2.62 ± 1.2) y el tartamudeo (M = 2.34 ± 1.3). En lo relativo a las estrategias de afrontamiento que aplican con mayor frecuencia los nadadores son: ejercitarse (M = 3.59 ± 1.35), buscar la solución del problema (M = 3.51 ± 1.35) y pensar positivamente (M = 3.51 ± 1.31). Concluyendo que el pensar positivamente, les permite reducir sus niveles de preocupación, inseguridad y desesperación pre competitiva, por lo que se asume que los niveles de estrés percibidos se encuentran en un nivel moderado.This transversal descriptive research aimed to characterize the stress-precompetitive 123 swimmer's category Mexican master. The age of participants ranged between 36 and 92 years old. The instrument used to collect information was the questionnaire FUSIES (sources, symptoms and stress coping strategies), this was applied before starting a master serial belonging to national swimming competition. The instrument measures perceived stress, under a Likert scale from 1 = never and 5 = extreme, with Cronbach's alpha of .95. Among the main results normal low stress (M = 2,307 ± 0.5) was observed in swimmers; sources that generate greater stress are the injustice of authorities (M = 3.70 ± 1.2), a lot of traffic (M = 3.48 ± 1.1) and no money (M= 3.28 ± 1.2). In turn, symptoms of stress with the highest score in swimmers is Concern (M= 2.96 ± 1.08), the back strain (M= 2.62 ± 1.2) and stuttering (M= 2.34 ± 1.3). Regarding coping strategies most frequently applied swimmers are: exercise (M= 3.59 ± 1.35), finding the solution (M = 3.51 ± 1.35) and think positively (M = 3.51 ± 1.31). Think positively concluding that allows them to reduce their levels of concern, insecurity and desperation pre-competitive, so it is assumed that levels of perceived stress are at a moderate level.Esta pesquisa descritiva transversal objetivou caracterizar a 123 nadadores o estresse pré-competitiva na natação master mexicana. A idade dos participantes variou entre 36 e 92 anos de idade. O instrumento utilizado para coleta de informações foi o FUSIES (fontes, sintomas e estratégias de confronto do estresse), este foi aplicado antes de iniciar um serial master da competição nacional de natação. O instrumento mediu o estresse percebido com a escala de Likert de 1 = nunca e 5 = sempre, com alfa de Cronbach 0,95. Entre os principais resultados o nível normail-baixo de estresse (M = 2,307 ± 0,5) foi observada nos nadadores; fontes que geram uma maior estresse são a injustiça das autoridades (M = 3,70 ± 1,2), tráfego (M = 3,48 ± 1,1) e não ter dinheiro (M = 3,28 ± 1,2). Por sua vez, sintomas de estresse com o maior número de pontos em nadadores é a preocupação (M = 2,96 ± 1,08), a tensão nas costas (M = 2,62 ± 1,2) e tartamudez (M = 2,34 ± 1,3). No que diz respeito as estratégias de confronto mais frequentemente aplicada pelos nadadores são fazer exercício (M = 3,59 ± 1,35), procurar a solução do problema (M = 3,51 ± 1,35) e pensamento positivo (M = 3,51 ± 1,31). Concluindo que o pensamento positivo, permite-lhes reduzir os seus níveis de preocupação, insegurança e desespero pré competitivo, por isso, assumese que os níveis de estresse percebido estão em um nível moderado

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad

Acta de congresoLa conmemoración de los cien años de la Reforma Universitaria de 1918 se presentó como una ocasión propicia para debatir el rol de la historia, la teoría y la crítica en la formación y en la práctica profesional de diseñadores, arquitectos y urbanistas. En ese marco el VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad constituyó un espacio de intercambio y reflexión cuya realización ha sido posible gracias a la colaboración entre Facultades de Arquitectura, Urbanismo y Diseño de la Universidad Nacional y la Facultad de Arquitectura de la Universidad Católica de Córdoba, contando además con la activa participación de mayoría de las Facultades, Centros e Institutos de Historia de la Arquitectura del país y la región. Orientado en su convocatoria tanto a docentes como a estudiantes de Arquitectura y Diseño Industrial de todos los niveles de la FAUD-UNC promovió el debate de ideas a partir de experiencias concretas en instancias tales como mesas temáticas de carácter interdisciplinario, que adoptaron la modalidad de presentación de ponencias, entre otras actividades. En el ámbito de VIII Encuentro, desarrollado en la sede Ciudad Universitaria de Córdoba, se desplegaron numerosas posiciones sobre la enseñanza, la investigación y la formación en historia, teoría y crítica del diseño, la arquitectura y la ciudad; sumándose el aporte realizado a través de sus respectivas conferencias de Ana Clarisa Agüero, Bibiana Cicutti, Fernando Aliata y Alberto Petrina. El conjunto de ponencias que se publican en este Repositorio de la UNC son el resultado de dos intensas jornadas de exposiciones, cuyos contenidos han posibilitado actualizar viejos dilemas y promover nuevos debates. El evento recibió el apoyo de las autoridades de la FAUD-UNC, en especial de la Secretaría de Investigación y de la Biblioteca de nuestra casa, como así también de la Facultad de Arquitectura de la UCC; va para todos ellos un especial agradecimiento

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Fuentes, síntomas y estrategias de afrontamiento al estrés-competitivo en nadadores

La presente investigación de tipo descriptivo transversal tuvo como objetivo caracterizar el estrés precompetitivo de 123 nadadores mexicanos de categoría master. La edad de los participantes osciló entre los 36 y 92 años de edad. El instrumento utilizado para recoger la información fue el cuestionario FUSIES (fuentes, síntomas y estrategias de afrontamiento al estrés), este se aplicó antes de iniciar una competencia nacional perteneciente al serial master de natación. El instrumento midió la percepción del estrés, bajo una escala tipo Likert de 1= nunca y 5 = extremo, con alfa de Cronbach de .95. Entre los principales resultados se observó un nivel normal bajo de estrés (M = 2.307 ± .5) en los nadadores; las fuentes que generan mayor estrés son la injusticia de autoridades (M = 3.70 ± 1.2), mucho tráfico (M = 3.48 ± 1.1) y no tener dinero (M = 3.28 ± 1.2). A su vez, los síntomas de estrés con mayor puntaje en los nadadores es la preocupación (M = 2.96 ± 1.08), la tensión en la espalda (M = 2.62 ± 1.2) y el tartamudeo (M = 2.34 ± 1.3). En lo relativo a las estrategias de afrontamiento que aplican con mayor frecuencia los nadadores son: ejercitarse (M = 3.59 ± 1.35), buscar la solución del problema (M = 3.51 ± 1.35) y pensar positivamente (M = 3.51 ± 1.31). Concluyendo que el pensar positivamente, les permite reducir sus niveles de preocupación, inseguridad y desesperación pre competitiva, por lo que se asume que los niveles de estrés percibidos se encuentran en un nivel moderado.This transversal descriptive research aimed to characterize the stress-precompetitive 123 swimmer's category Mexican master. The age of participants ranged between 36 and 92 years old. The instrument used to collect information was the questionnaire FUSIES (sources, symptoms and stress coping strategies), this was applied before starting a master serial belonging to national swimming competition. The instrument measures perceived stress, under a Likert scale from 1 = never and 5 = extreme, with Cronbach's alpha of .95. Among the main results normal low stress (M = 2,307 ± 0.5) was observed in swimmers; sources that generate greater stress are the injustice of authorities (M = 3.70 ± 1.2), a lot of traffic (M = 3.48 ± 1.1) and no money (M= 3.28 ± 1.2). In turn, symptoms of stress with the highest score in swimmers is Concern (M= 2.96 ± 1.08), the back strain (M= 2.62 ± 1.2) and stuttering (M= 2.34 ± 1.3). Regarding coping strategies most frequently applied swimmers are: exercise (M= 3.59 ± 1.35), finding the solution (M = 3.51 ± 1.35) and think positively (M = 3.51 ± 1.31). Think positively concluding that allows them to reduce their levels of concern, insecurity and desperation pre-competitive, so it is assumed that levels of perceived stress are at a moderate level.Esta pesquisa descritiva transversal objetivou caracterizar a 123 nadadores o estresse pré-competitiva na natação master mexicana. A idade dos participantes variou entre 36 e 92 anos de idade. O instrumento utilizado para coleta de informações foi o FUSIES (fontes, sintomas e estratégias de confronto do estresse), este foi aplicado antes de iniciar um serial master da competição nacional de natação. O instrumento mediu o estresse percebido com a escala de Likert de 1 = nunca e 5 = sempre, com alfa de Cronbach 0,95. Entre os principais resultados o nível normail-baixo de estresse (M = 2,307 ± 0,5) foi observada nos nadadores; fontes que geram uma maior estresse são a injustiça das autoridades (M = 3,70 ± 1,2), tráfego (M = 3,48 ± 1,1) e não ter dinheiro (M = 3,28 ± 1,2). Por sua vez, sintomas de estresse com o maior número de pontos em nadadores é a preocupação (M = 2,96 ± 1,08), a tensão nas costas (M = 2,62 ± 1,2) e tartamudez (M = 2,34 ± 1,3). No que diz respeito as estratégias de confronto mais frequentemente aplicada pelos nadadores são fazer exercício (M = 3,59 ± 1,35), procurar a solução do problema (M = 3,51 ± 1,35) e pensamento positivo (M = 3,51 ± 1,31). Concluindo que o pensamento positivo, permite-lhes reduzir os seus níveis de preocupação, insegurança e desespero pré competitivo, por isso, assumese que os níveis de estresse percebido estão em um nível moderado