Satisfacción del usuario del servicio de medicina interna sobre la calidad de atención en el Hospital Daniel Alcides Carrión, Huancayo – Perú: Patient satisfaction and quality of care of the internal medicine service of Hospital Daniel Alcides Carrión. Huancayo - Perú

Introduction: Patient satisfaction is an indicator of the quality of care provided in health services.Knowing the level of satisfaction will improve deficiencies and reaffirm strengths to develop a healthsystem that provides the quality care that patients demand. Objective: To determine the satisfactionof the quality of service of patients of external Internal Medicine consultation of Hospital Daniel AlcidesCarrión - Huancayo, from July to November 2016. Methods: Observational, descriptive, cross-sectionalstudy. The sample consisted of 292 patients. The quality of service in the health system according topatient satisfaction was measured using the standardized SERVQUAL questionnaire. Results: 57% ofthe sample was female, the ages of the participants ranged from 36 to 45 years. Similarly, 36% of usershad complete secondary education and 63% were continuing patients. Overall satisfaction was 60.3%.The percentage values depended on the dimensions of safety and empathy with 86.8% and 80.3%satisfaction, respectively. The highest level of dissatisfaction was obtained by the dimension of tangibleaspects with 57.1% of dissatisfied users, followed by the dimension of responsiveness of health serviceswith 55.5% of dissatisfaction. Conclusions: the health system must implement strategies to improvecare services to provide timely and quality care to users.Introducción: La satisfacción del usuario es un indicador de calidad de atención prestada en losservicios de salud. Conocer el nivel de satisfacción permitirá mejorar falencias y reafirmar fortalezas afin de desarrollar un sistema de salud que brinde la atención de calidad que los pacientes demandan.Objetivo: Determinar la satisfacción de la calidad del servicio de los usuarios de consulta externode medicina interna del hospital Daniel Alcides Carrión - Huancayo, de julio a noviembre del 2016.Métodos: Estudio observacional, descriptivo, de corte transversal. La muestra estuvo conformada por292 pacientes. La calidad del servicio del sistema de salud en función de la satisfacción del usuario semidió mediante el cuestionario estandarizado SERVQUAL. Resultados: El 57% de la muestra fue desexo femenino, el rango de edades de los participantes osciló entre 36 a 45 años. Asímismo, el 36% delos usuarios contaba con educación secundaria completa y el 63% fueron pacientes continuadores.Se obtuvo una satisfacción global de 60,3%. Los valores porcentuales dependieron básicamentede las dimensiones seguridad y empatía con 86,8 % y 80,3 % de satisfacción respectivamente. Elmayor nivel de insatisfacción la obtuvo la dimensión de aspectos tangibles con el 57,1 % de usuariosinsatisfechos, seguida de la dimensión de capacidad de respuesta de los servicios de salud con el55,5% de insatisfacción. Conclusión: El sistema de salud debe implementar estrategias de mejora delos servicios de atención con el fin de proporcionar una atención oportuna y de calidad a los usuarios

Seedling Production Systems for Smallholder Forestry Development: Local Practices versus National Policies in the Philippines

The tree seedling nursery sector in the Philippines is influenced by a number of national level policies affecting the number and type of species produced. Policies favour high-volume production of a limited range of mostly exotic species, and research indicates that seedlings are often of low physical and genetic quality. Local knowledge on best species for sites is not being communicated to people planting. A project funded by the Australian Centre for International Agricultural Research is investigating measures to improve the performance and effectiveness of the forestry seedling production system in Leyte and Mindanao in the Philippines. Seedlings are produced by government agencies, in community forestry projects and by individual private operators; the main customers are smallholder tree farmers. Communities and private individuals quickly set up nurseries when there is a demand for seedlings, but these nurseries tend to be ephemeral and lack financial sustainability. While large nurseries offer opportunities for economies of scale, small nurseries operate on a low cost basis, and are more widely distributed, and their seedlings are more accessible to smallholders, who lack transport facilities. Small private nurseries, while having limited access to new technology, often produce seedlings of quality similar to government and community nurseries. However, they require assistance in access to high-quality germplasm and training in improved seed production technology, to play a greater role in expansion of plantation forestry. This paper reports survey findings on seedling production systems, and examines the link between national level policies and local level practices

An easy to control all-metal in-line-series ohmic RF MEMS switch

Copyright @ 2010 Springer-VerlagThe analysis, design and simulation of a novel easy to control all-metal in-line-series ohmic RF MEMS switch is presented, for applications where the operating frequency ranges from DC to 4 GHz. The proposed switch, due to its unique shape and size, assures high isolation and great linearity fulfilling the necessary requirements as concerns loss, power handling and power consumption. Simplicity has been set as the key success factor implying robustness and high fabrication yield. On the other hand, the specially designed cantilever-shape (hammerhead) allows distributed actuation force ensuring high controllability as well as reliability making the presented RF MEMS switch one of its kind

Nanostructural changes in cell wall pectins during strawberry fruit ripening assessed by atomic force microscopy

Rapid loss of firmness occurs during strawberry (Fragaria × ananassa Duch) ripening, resulting in a short shelf life and high economic losses. The disassembly of cell walls is considered the main responsible for fruit softening, being pectins extensively modified during strawberry ripening (Paniagua et al. 2014). Atomic force microscopy allows the analysis of individual polymer chains at nanostructural level with a minimal sample preparation (Morris et al., 2001). The main objective of this research was to compare pectins of green and red ripe strawberry fruits at the nanostructural level to shed light on structural changes that could be related to softening. Cell walls from strawberry fruits were extracted and fractionated with different solvents to obtain fractions enriched in a specific component. The yield of cell wall material, as well as the amount of the different fractions, decreased in ripe fruits. CDTA and Na2CO3 fractions underwent the largest decrements, being these fractions enriched in pectins supposedly located in the middle lamella and primary cell wall, respectively. Uronic acid content also decreased significantly during ripening in both pectin fractions, but the amount of soluble pectins, those extracted with phenol:acetic acid:water (PAW) and water increased in ripe fruits. Monosaccharide composition in CDTA and Na2CO3 fractions was determined by gas chromatography. In both pectin fractions, the amount of Ara and Gal, the two most abundant carbohydrates, decreased in ripe fruits. The nanostructural characteristics of CDTA and Na2CO3 pectins were analyzed by AFM. Isolated pectic chains present in the CDTA fraction were significantly longer and more branched in samples from green fruits than those present in samples obtained from red fruit. In spite of slight differences in length distributions, Na2CO3 samples from unripe fruits displayed some longer chains at low frequency that were not detected in ripe fruits. Pectin aggregates were more frequently observed in green fruit samples from both fractions. These results support that pectic chain length and the nanostructural complexity of the pectins present in CDTA and Na2CO3 fractions diminish during strawberry fruit development, and these changes, jointly with the loss of neutral sugars, could contribute to the solubilization of pectins and fruit softening. Paniagua et al. (2014). Ann Bot, 114: 1375-1383 Morris et al. (2001). Food Sci Tech 34: 3-10 This research was supported by FEDER EU Funds and the Ministerio de Educación y Ciencia of Spain (grant reference AGL2011-24814)Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Unravelling the nanostructure of strawberry fruit pectins by atomic force microscopy

Atomic force microscopy (AFM) allows the analysis of individual polymers at nanostructural level with a minimal sample preparation. This technique has been used to analyse the pectin disassembly process during the ripening and postharvest storage of several fleshy fruits. In general, pectins analysed by AFM are usually visualized as isolated chains, unbranched or with a low number of branchs and, occasionally, as large aggregates. However, the exact nature of these structures is unknown. It has been suggested that pectin aggregates represent a mixture of rhamnonogalacturonan I and homogalacturonan, while isolated chains and their branches are mainly composed by polygalacturonic acid. In order to gain insight into the nature of these structures, sodium carbonate soluble pectins from ripe strawberry (Fragaria x ananassa, Duch.) fruits were subjected to enzymatic digestion with endo-Polygalacturonase M2 from Aspergillus aculeatus, and the samples visualized by AFM at different time intervals. Pectins isolated from control, non-transformed plants, and two transgenic genotypes with low level of expression of ripening-induced pectinase genes encoding a polygalacturonase (APG) or a pectate lyase (APEL) were also included in this study. Before digestion, isolated pectin chains from control were shorter than those from transgenic fruits, showing number-average (LN) contour length values of 73.2 nm vs. 95.9 nm and 91.4 nm in APG and APEL, respectively. The percentage of branched polymers was significantly higher in APG polyuronides than in the remaining genotypes, 33% in APG vs. 6% in control and APEL. As a result of the endo-PG treatment, a gradual decrease in the main backbone length of isolated chains was observed in the three samples. The minimum LN value was reached after 8 h of digestion, being similar in the three genotypes, 22 nm. By contrast, the branches were not visible after 1.5-2 h of digestion. LN values were plotted against digestion time and the data fitted to a first-order exponential decay curve, obtaining R2 values higher than 0.9. The half digestion time calculated with these equations were similar for control and APG pectins, 1.7 h, but significantly higher in APEL, 2.5 h, indicating that these polymer chains were more resistant to endo-PG digestion. Regarding the pectin aggregates, their volumes were estimated and used to calculate LN molecular weights. Before digestion, control and APEL samples showed complexes of similar molecular weights, 1722 kDa, and slightly higher than those observed in APG samples. After endo-PG digestion, size of complexes diminished significantly, reaching similar values in the three pectin samples, around 650 kDa. These results suggest that isolated polymer chains visualized by AFM are formed by a HG domain linked to a shorter polymer resistant to endo-PG digestion, maybe xylogalacturonan or RG-I. The silencing of the pectate lyase gene slightly modified the structure and/or chemical composition of polymer chains making these polyuronides more resistant to enzymatic degradation. Similarly, polygalacturonic acid is one of the main component of the aggregates.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Weak charge form factor and radius of 208Pb through parity violation in electron scattering

We use distorted wave electron scattering calculations to extract the weak charge form factor F_W(q), the weak charge radius R_W, and the point neutron radius R_n, of 208Pb from the PREX parity violating asymmetry measurement. The form factor is the Fourier transform of the weak charge density at the average momentum transfer q=0.475 fm$^{-1}$. We find F_W(q) =0.204 \pm 0.028 (exp) \pm 0.001 (model). We use the Helm model to infer the weak radius from F_W(q). We find R_W= 5.826 \pm 0.181 (exp) \pm 0.027 (model) fm. Here the exp error includes PREX statistical and systematic errors, while the model error describes the uncertainty in R_W from uncertainties in the surface thickness \sigma of the weak charge density. The weak radius is larger than the charge radius, implying a "weak charge skin" where the surface region is relatively enriched in weak charges compared to (electromagnetic) charges. We extract the point neutron radius R_n=5.751 \pm 0.175 (exp) \pm 0.026 (model) \pm 0.005 (strange) fm$, from R_W. Here there is only a very small error (strange) from possible strange quark contributions. We find R_n to be slightly smaller than R_W because of the nucleon's size. Finally, we find a neutron skin thickness of R_n-R_p=0.302\pm 0.175 (exp) \pm 0.026 (model) \pm 0.005 (strange) fm, where R_p is the point proton radius.Comment: 5 pages, 1 figure, published in Phys Rev. C. Only one change in this version: we have added one author, also to metadat

Technical note: A simple theoretical model framework to describe plant stomatal “sluggishness” in response to elevated ozone concentrations

Elevated levels of tropospheric ozone, O3, cause damage to terrestrial vegetation, affecting leaf stomatal functioning and reducing photosynthesis. Climatic impacts under future raised atmospheric greenhouse gas (GHG) concentrations will also impact on the net primary productivity (NPP) of vegetation, which might for instance alter viability of some crops. Together, ozone damage and climate change may adjust the current ability of terrestrial vegetation to offset a significant fraction of carbon dioxide (CO2) emissions. Climate impacts on the land surface are well studied, but arguably large-scale modelling of raised surface level O3 effects is less advanced. To date most models representing ozone damage use either O3 concentration or, more recently, flux-uptake-related reduction of stomatal opening, estimating suppressed land–atmosphere water and CO2 fluxes. However there is evidence that, for some species, O3 damage can also cause an inertial “sluggishness” of stomatal response to changing surface meteorological conditions. In some circumstances (e.g. droughts), this loss of stomata control can cause them to be more open than without ozone interference. To both aid model development and provide empiricists with a system on to which measurements can be mapped, we present a parameter-sparse framework specifically designed to capture sluggishness. This contains a single time-delay parameter τO3, characterizing the timescale for stomata to catch up with the level of opening they would have without damage. The larger the value of this parameter, the more sluggish the modelled stomatal response. Through variation of τO3, we find it is possible to have qualitatively similar responses to factorial experiments with and without raised O3, when comparing to reported measurement time series presented in the literature. This low-parameter approach lends itself to the inclusion of ozone-induced inertial effects being incorporated in the terrestrial vegetation component of Earth system models (ESMs)

Efectividad del agua electrolizada oxidadora (EO) en la inactivación de Listeria monocytogenes en lechuga ( Lactuca sativa L.)

Se evaluó la efectividad del agua electrolizada oxidadora (EO) en la inactivación de Listeria monocytogenes en lechuga; para ello se construyó una celda electrolítica para la producción de agua EO a partir de una solución de NaCl al 5%, con una concentración de cloro residual de 29 partes por millón (ppm) y pH 2.83. Cinco de las 10 cepas de Listeria monocytogenes mas resistentes a la acción del hipoclorito de sodio , fueron obtenidas a partir de muestras de pollo procesado e inoculadas en 9 ml de agua EO o 9 ml de agua desionizada estéril (control) e incubadas a 15°C durante 5, 10, 15 y 20 minutos. La población se determinó por recuento en placa en agar Columbia, obteniéndose una reducción de 6.6 UL a los 5 minutos de exposición. Las cepas seleccionadas fueron utilizadas como suspensión mixta (9.56 UL, 10 9 UFC/ml) para inocular 35 lechugas por el método de inmersión. Se sumergieron 6.25 g de cada lechuga en 375 ml de agua EO o agua destilada (control) a 15 °C durante 5 minutos. La población promedio de Listeria monocytogenes después del tratamiento con agua EO y con agua destilada, se redujo en 3.92 y 2.46 UL respectivamente. Se demostró que el agua EO tiene un efecto bactericida estadísticamente significativo (p=0.00001). Para mejorar el efecto del agua EO sobre L. monocytogenes en lechuga, se evaluó su efectividad en combinación con ácido acético al 6% (vinagre). Reducción de la población en 5.49 UL demuestran que hay un efecto sinergista de ambos agentes antimicrobianos sobre la viabilidad de las células de L. monocytogenes