369 research outputs found

    Investigación de mercado para la apertura de nuevas sucursales de clínica de fisioterapia y sus estrategias de lanzamiento

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    La empresa Biokinesic es una cadena de clínicas de rehabilitación y fisioterapia en proceso de expansión, por lo que contactó al Centro de Desarrollo para la Comercialización de ITESO, para realizar una investigación de mercado con el objetivo de identificar las localidades con potencial para abrir nuevas sucursales y expandirse por todo el territorio mexicano. El presente proyecto PAP es el análisis de dichas plazas, así como la propuesta de estrategias de apertura para estos nuevos locales.ITESO, A.C

    Estimation of cause-specific mortality in Rakai, Uganda, using verbal autopsy 1999-2019

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    BackgroundThere are scant data on the causes of adult deaths in sub-Saharan Africa. We estimated the level and trends in adult mortality, overall and by different causes, in rural Rakai, Uganda, by age, sex, and HIV status.ObjectivesTo estimate and analyse adult cause-specific mortality trends in Rakai, Uganda.MethodologyMortality information by cause, age, sex, and HIV status was recorded in the Rakai Community Cohort study using verbal autopsy interviews, HIV serosurveys, and residency data. We estimated the average number of years lived in adulthood. Using demographic decomposition methods, we estimated the contribution of each cause of death to adult mortality based on the average number of years lived in adulthood.ResultsBetween 1999 and 2019, 63082 adults (15–60 years) were censused, with 1670 deaths registered. Of these, 1656 (99.2%) had completed cause of death data from verbal autopsy. The crude adult death rate was 5.60 (95% confidence interval (CI): 5.33–5.87) per 1000 person-years of observation (pyo). The crude death rate decreased from 11.41 (95% CI: 10.61–12.28) to 3.27 (95% CI: 2.89–3.68) per 1000 pyo between 1999–2004 and 2015–2019. The average number of years lived in adulthood increased in people living with HIV and decreased in HIV-negative individuals between 2000 and 2019. Communicable diseases, primarily HIV and Malaria, had the biggest decreases, which improved the average number of years lived by approximately extra 12 years of life in females and 6 years in males. There were increases in deaths due to non-communicable diseases and external causes, which reduced the average number of years lived in adulthood by 2.0 years and 1.5 years in females and males, respectively.ConclusionThere has been a significant decline in overall mortality from 1999 to 2019, with the greatest decline seen in people living with HIV since the availability of antiretroviral therapy in 2004. By 2020, the predominant causes of death among females were non-communicable diseases, with external causes of death dominating in males

    Net survival of perinatally and postnatally HIV-infected children: a pooled analysis of individual data from sub-Saharan Africa

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    Background Previously, HIV epidemic models have used a double Weibull curve to represent high initial and late mortality of HIV-infected children, without distinguishing timing of infection (peri- or post-natally). With more data on timing of infection, which may be associated with disease progression, a separate representation of children infected early and late was proposed. Methods Paediatric survival post-HIV infection without anti-retroviral treatment was calculated using pooled data from 12 studies with known timing of HIV infection. Children were grouped into perinatally or post-natally infected. Net mortality was calculated using cause-deleted life tables to give survival as if HIV was the only competing cause of death. To extend the curve beyond the available data, children surviving beyond 2.5 years post infection were assumed to have the same survival as young adults. Double Weibull curves were fitted to both extended survival curves to represent survival of children infected perinatally or through breastfeeding. Results Those children infected perinatally had a much higher risk of dying than those infected through breastfeeding, even allowing for background mortality. The final-fitted double Weibull curves gave 75% survival at 5 months after infection for perinatally infected, and 1.1 years for post-natally infected children. An estimated 25% of the early infected children would still be alive at 10.6 years compared with 16.9 years for those infected through breastfeeding. Conclusions The increase in available data has enabled separation of child mortality patterns by timing of infection allowing improvement and more flexibility in modelling of paediatric HIV infection and surviva

    Scale issues in soil moisture modelling: problems and prospects

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    Soil moisture storage is an important component of the hydrological cycle and plays a key role in land-surface-atmosphere interaction. The soil-moisture storage equation in this study considers precipitation as an input and soil moisture as a residual term for runoff and evapotranspiration. A number of models have been developed to estimate soil moisture storage and the components of the soil-moisture storage equation. A detailed discussion of the impli cation of the scale of application of these models reports that it is not possible to extrapolate processes and their estimates from the small to the large scale. It is also noted that physically based models for small-scale applications are sufficiently detailed to reproduce land-surface- atmosphere interactions. On the other hand, models for large-scale applications oversimplify the processes. Recently developed physically based models for large-scale applications can only be applied to limited uses because of data restrictions and the problems associated with land surface characterization. It is reported that remote sensing can play an important role in over coming the problems related to the unavailability of data and the land surface characterization of large-scale applications of these physically based models when estimating soil moisture storage.Yeshttps://us.sagepub.com/en-us/nam/manuscript-submission-guideline

    SPEAR: The Next Generation GFDL Modeling System for Seasonal to Multidecadal Prediction and Projection

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    We document the development and simulation characteristics of the next generation modeling system for seasonal to decadal prediction and projection at the Geophysical Fluid Dynamics Laboratory (GFDL). SPEAR (Seamless System for Prediction and EArth System Research) is built from component models recently developed at GFDL—the AM4 atmosphere model, MOM6 ocean code, LM4 land model, and SIS2 sea ice model. The SPEAR models are specifically designed with attributes needed for a prediction model for seasonal to decadal time scales, including the ability to run large ensembles of simulations with available computational resources. For computational speed SPEAR uses a coarse ocean resolution of approximately 1.0° (with tropical refinement). SPEAR can use differing atmospheric horizontal resolutions ranging from 1° to 0.25°. The higher atmospheric resolution facilitates improved simulation of regional climate and extremes. SPEAR is built from the same components as the GFDL CM4 and ESM4 models but with design choices geared toward seasonal to multidecadal physical climate prediction and projection. We document simulation characteristics for the time mean climate, aspects of internal variability, and the response to both idealized and realistic radiative forcing change. We describe in greater detail one focus of the model development process that was motivated by the importance of the Southern Ocean to the global climate system. We present sensitivity tests that document the influence of the Antarctic surface heat budget on Southern Ocean ventilation and deep global ocean circulation. These findings were also useful in the development processes for the GFDL CM4 and ESM4 models

    Influence of soil and climate on root zone storage capacity

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    Root zone storage capacity (Sr) is an important variable for hydrology and climate studies, as it strongly influences the hydrological functioning of a catchment and, via evaporation, the local climate. Despite its importance, it remains difficult to obtain a wellâ founded catchment representative estimate. This study tests the hypothesis that vegetation adapts its Sr to create a buffer large enough to sustain the plant during drought conditions of a certain critical strength (with a certain probability of exceedance). Following this method, Sr can be estimated from precipitation and evaporative demand data. The results of this â climateâ based methodâ are compared with traditional estimates from soil data for 32 catchments in New Zealand. The results show that the differences between catchments in climateâ derived catchment representative Sr values are larger than for soilâ derived Sr values. Using a model experiment, we show that the climateâ derived Sr can better reproduce hydrological regime signatures for humid catchments; for more arid catchments, the soil and climate methods perform similarly. This makes the climateâ based Sr a valuable addition for increasing hydrological understanding and reducing hydrological model uncertainty.Key Points:Plants develop their root systems to survive droughtsModel root zone storage capacity (Sr) can be inferred from climate recordsModel experiment shows that Sr is stronger influenced by climate than by soilPeer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137190/1/wrcr21890.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137190/2/wrcr21890_am.pd
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