Impactos ambientales de la infraestructura vial en el caribe colombiano, un análisis desde la perspectiva regional

The construction of road infrastructure produces impacts and/or variations in the environment. Given the growing road infrastructure in the Colombian Caribbean region, there are threats to the balance of the systems that make it up, so that the ecosystem services present modifications in their natural conditions. In spite of the various administrative tools available in Colombian legislation to identify and mitigate the impacts caused to ecosystems by the projects being executed, the current general panorama shows that the scope of compensation measures is limited for interconnected regional ecosystems. This document presents an analysis study of eight cases of Environmental Impact Assessments (EIA) of road projects in the region, thus, it evaluates with established criteria which are the effects that have the greatest impact on a macro scale that is not currently evaluated by the available management tools. For this purpose, a review of the contributions of scientific and institutional literature was carried out in order to identify the environmental problems that are generated on a large scale with the interconnection of roads in the Colombian Caribbean, and that today there is no clarity of these effects at this scale of study. This document presents recommendations from an integrated analysis perspective for future projects to understand the alteration of the landscape and water systems at a regional scale.La construcción de infraestructura vial produce impactos y/o variaciones en el medio ambiente. Ante la creciente infraestructura vial en la región Caribe colombiana, existen amenazas para el equilibrio de los sistemas que la conforman, de manera que, los servicios ecosistémicos presenten modificaciones en sus condiciones naturales. A pesar de las diversas herramientas administrativas disponibles en la legislación colombiana para identificar y mitigar los impactos ocasionados a los ecosistemas de los proyectos que se ejecutan, el panorama general actual muestra que el alcance de las medidas de compensación es limitado para los ecosistemas regionales interconectados. En este documento se expone un estudio de análisis de ocho casos de Estudios de Impacto Ambiental (EIA) de proyectos viales en la región, así, se evalúa con criterios establecidos cuáles son las afectaciones que tienen mayor incidencia en una macro escala que actualmente no está evaluada por las herramientas de gestión disponibles. Para ello, se realizó una revisión de los aportes de la literatura científica e institucional, con el fin de identificar los problemas ambientales que se generan a gran escala con la interconexión de vías en el Caribe Colombiano, y que hoy en día no existe claridad de estos efectos a esta escala de estudio. En este documento se presentan recomendaciones desde una perspectiva de análisis integrado para proyectos futuros de tal forma se comprenden la alteración del paisaje y los sistemas de agua a escala regional

Violencia familiar e inteligencia emocional en adolescentes

El estudio denominado ``Violencia familiar e inteligencia emocional en adolescentes``, estableció como principal objetivo identificar la relación entre, la violencia familiar y la inteligencia emocional. En virtud de lo cual, se empleó un enfoque cuantitativo, de tipo descriptivo no experimental en una población muestral de 225 adolescentes del distrito de Sullana, quienes presentan entre 11 y 18 años y cursan el nivel secundario. El cuestionario de violencia familiar (VIFA) creado por Altamirano y castro (2013) y el Inventario de inteligencia emocional BarOn Ice (forma abreviada): adaptado por Ugarriza y Pajares (2005), fueron utilizados como herramientas para el proceso de recopilación de datos; los cuales reportan que, hay una relación negativa Baja (-0,284) entre las variables analizadas con una significancia menor a 0,05 (p=0,000). Así mismo, se encontró que, entre violencia Psicológica y las dimensiones de inteligencia emocional hay una relación negativa con el Manejo de estrés (-0,405), Adaptabilidad (-0,140), e Impresión Positiva (- 0,245). Mientras que la violencia Física tiene una relación negativa con la dimensión de manejo de Stress (-0,238) y con la dimensión Impresión Positiva (-0,228). Concerniente a los niveles prevalecientes, se evidencia que el 82.2% presenta un nivel moderado de violencia familiar, mientras que en inteligencia emocional prevalece el nivel que necesita mejorarse con un 38,7%. Por otro lado, se identificó que la violencia física se presenta en mayor porcentaje en la población masculina

Roads of the Caribbean: regional analysis from Environmental Impact Assessments in Colombia

The road infrastructure produces several impacts on the environment. In the Colombian Caribbean region, the growing road infrastructure threatens systems equilibrium in diverse and not well-known ways. Despite the several administrative tools available in Colombian legislation to manage every project impact, the big picture of the interconnected regional ecosystems falls out of scope. To study the large-scale problems in landscape, we analyzed eight Environmental Impact Studies of road construction projects in the region. We did a scientific and institutional literature review to shed light on the possible unseen problems and future challenges. Results suggest that Environmental Impact Assessments for each project focus on construction processes, ignore accumulative and residual effects, and use typified measures to cover a broad set of impacts. We offer recommendations from an integrated analysis perspective for future projects to understand landscape and water systems alteration at the regional scale

DISEÑO DE UN UTILLAJE PARA LA EXTRACCIÓN DE TORNILLOS MILIMÉTRICOS DE FIJACIÓN ÓSEA BAJO LA NORMA ASTM F543 (DESIGN OF A FIXTURE FOR PULL OUT TEST OF MILLIMETRIC BONE FIXING SCREWS GUIDED BY ASTM F543 STANDARD)

Resumen Los tornillos corticales son elementos utilizados en osteosíntesis para la fijación de fracturas, la estabilidad de la fijación del tornillo es principalmente el resultado del anclaje efectivo del tornillo, una mala estabilidad lleva al fracaso de la unión del hueso. Con base en las normas ASTM F543, se diseñó un herramental para la realización de pruebas de la resistencia a la extracción en tornillos corticales, esto con la finalidad de comparar diferentes tornillos médicos utilizados en osteosíntesis. Se identificaron los principales parámetros que influyen en la resistencia a la extracción de los tornillos y se diseñó un herramental para la realización de las pruebas, el cual cumple con los parámetros asignados por la norma ASTM F 543. Palabras clave:Espuma de poliuretano, fuerza de extracción, tornillo cortical. Abstract Cortical screws are elements used in osteosynthesis for the fixation of fractures, the stability of the fixation of the screw is mainly the result of the effective anchoring of the screw, poor stability leads to failure of the bone union. Based on the ASTM F543 standards, a tool was designed to carry out tests of the resistance to extraction in cortical screws, in order to compare different medical screws used in osteosynthesis. The main parameters that influence the resistance to extraction of the screws were identified and a fixture was designed to carry out the tests, which complies with the parameters assigned by the ASTM F 543 standard. Keywords:Cortical screw, pull-out force, rigid polyurethane foam

EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis: rationale, design, and study protocol of a large-scale epidemiological study in Europe

Background: The growing prevalence of eosinophilic esophagitis (EoE) represents a considerable burden to patients and health care systems. Optimizing cost-effective management and identifying mechanisms for disease onset and progression are required. However, the paucity of large patient cohorts and heterogeneity of practice hinder the defining of optimal management of EoE. Methods: EoE CONNECT is an ongoing, prospective registry study initiated in 2016 and currently managed by EUREOS, the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract. Patients are managed and treated by their responsible specialists independently. Data recorded using a web-based system include demographic and clinical variables; patient allergies; environmental, intrapartum, and early life exposures; and family background. Symptoms are structurally assessed at every visit; endoscopic features and histological findings are recorded for each examination. Prospective treatment data are registered sequentially, with new sequences created each time a different treatment (active principle, formulation, or dose) is administered to a patient. EoE CONNECT database is actively monitored to ensure the highest data accuracy and the highest scientific and ethical standards. Results: EoE CONNECT is currently being conducted at 39 centers in Europe and enrolls patients of all ages with EoE. In its aim to increase knowledge, to date EoE CONNECT has provided evidence on the effectiveness of first- and second-line therapies for EoE in clinical practice, the ability of proton pump inhibitors to induce disease remission, and factors associated with improved response. Drug effects to reverse fibrous remodeling and endoscopic features of fibrosis in EoE have also been assessed. Conclusion: This prospective registry study will provide important information on the epidemiological and clinical aspects of EoE and evidence as to the real-world and long-term effectiveness and safety of therapy. These data will potentially be a vital benchmark for planning future EoE health care services in Europe

Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry

BACKGROUND: Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. OBJECTIVE: To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. METHODS: Cross‐sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. RESULTS: Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7‐6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub‐score decreased from a median (IQR) of 2 (1‐2) to 0 (0‐1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively). CONCLUSION: The diagnostic work‐up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay

Jardins per a la salut

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia. Assignatura: Botànica farmacèutica. Curs: 2014-2015. Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són el recull de les fitxes botàniques de 128 espècies presents en el Jardí Ferran Soldevila de l’Edifici Històric de la UB. Els treballs han estat realitzats manera individual per part dels estudiants dels grups M-3 i T-1 de l’assignatura Botànica Farmacèutica durant els mesos de febrer a maig del curs 2014-15 com a resultat final del Projecte d’Innovació Docent «Jardins per a la salut: aprenentatge servei a Botànica farmacèutica» (codi 2014PID-UB/054). Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pels professors de l’assignatura. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica. També s’ha pretès motivar els estudiants a través del retorn de part del seu esforç a la societat a través d’una experiència d’Aprenentatge-Servei, deixant disponible finalment el treball dels estudiants per a poder ser consultable a través d’una Web pública amb la possibilitat de poder-ho fer in-situ en el propi jardí mitjançant codis QR amb un smartphone

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049