Efecto de la suplementación de Selenio orgánico de levadura (Saccharomyces cerevisiae) sobre los parámetros zootécnicos y hematocrito en pollos de engorde.

Actualmente la industria avícola en Colombia viene creciendo exponencialmente y las altas densidades son un reto para la producción, debido a que las aves están expuestas constantemente a enfermedades y elevados niveles de estrés, lo cual genera problemas fisiológicos, disminuyendo la producción y vulnerando la sanidad, por ende, la búsqueda de métodos que mejoren los parámetros productivos e inmunológicos en condiciones tropicales como Colombia es necesaria, como el uso de minerales que sirven como antioxidantes como el Se. El objetivo del presente trabajo fue determinar el efecto de la suplementación de Selenio orgánico de levadura (Saccharomyces cerevisiae) sobre los parámetros zootécnicos (mortalidad, peso corporal (gr), ganancia/Ave/Acumulada, conversión alimenticia, índice de productividad (IP)) y hematocrito en pollos de engorde. Este estudio contó con cinco grupos compuestos de 100 individuos aproximadamente, ubicados cada uno en un área de 10,8 m² con condiciones estándar de alimentación. Se utilizaron 5 programas de alimentación diferentes: los tres primeros tratamientos fueron suplementados a diferentes dosis de Selenio orgánico de levadura Saccharomyces cerevisiae (0,075 ppm, 0,15 ppm y 0,3 ppm), el cuarto tratamiento fue suplementado con 0,3 ppm de Selenito de sodio y un quinto grupo control con comida comercial sin ningún tipo de suplementación. No hubo diferencias significativas (P>0.05) que demuestre una respuesta positiva a la suplementación de diferentes dosis de Selenio orgánico de Levadura en ninguna de las variables evaluadas

El papel de las opciones reales en la valoración de una mina de cobre

El sector de la minería se caracteriza por la existencia de proyectos que poseen flexibilidad operativa y administrativa, debido a la alta volatilidad de los factores externos que afectan el desarrollo de estos proyectos. La metodología apropiada para valorar este tipo de proyectos son las opciones reales ya que incluyen el valor de la flexibilidad en el valor final del proyecto. En la valoración del proyecto minero de cobre se utiliza el método de árboles binomiales, con el cual se analiza y valoriza la opción de cierre temporal de la mina. El resultado de la valoración por este método aumenta en un 10,12% respecto al cálculo realizado por la metodología de valor presente neto, resaltando la importancia de valorar por medio de opciones reales para maximizar el valor total de los proyectos mineros.The mining sector is characterized by the existence of projects that have operational and administrative flexibility, due to the high volatility of external factors that affect the development of these projects. The appropriate methodology for evaluating this type of project is the real options since it includes the value of the flexibility in the final value of the project. In the valuation of the copper mining project, the binomial tree method is used to analyzed and valued the option of temporary closure of the mine in five periods. The result of the valuation shows that when assessing the project by this method, the value of the project in the zero period increased 10.12% with respect to the calculation made by the net present value methodology, showing the importance of valuing through real options to maximize the total value of mining projects

El potencial de la escritura creativa para agregar valor a la formulación de proyectos de innovación: estudio de caso sobre el aporte del guionista

To date, it has not been considered the contribution the creative writing can bring into academic research, since usually they are considered non correlated areas. In this work, it is proposed a framework and a practical case is implemented addressing the development of scripts with the appropriate characteristics, which adds value to the process of innovation projects formulation. It is proposed a critical and reflexive discussion about the potential contribution of the creative writing as a collaboration tool to be used in a script development, and the way how the script writing adds value to the investigative activity. Since the script writing continues to position itself as a type of creative writing, and the development of a script can be understood as an audiovisual production, it is relevant to bear in mind the fundamental concepts of the creative writing and the audiovisual production that can contribute the most to the process of innovation projects development.A la fecha, no se ha considerado el aporte que la escritura creativa le puede dar a la investigación académica, pues convencionalmente se consideran áreas poco relacionadas entre sí. En este trabajo se propone un marco conceptual y se presenta un caso práctico en el cual se desarrolló unos guiones con las características apropiadas, el cual agregó valor al proceso de formulación de proyectos de innovación. Se plantea una discusión crítica y reflexiva sobre el potencial aporte de la escritura creativa como herramienta de colaboración para usar en el desarrollo de un guion, y la manera como la escritura de guiones agrega valor a la actividad investigativa. Dado que la escritura de guiones se posiciona cada vez más como un tipo de escritura creativa, y el desarrollo de un guion puede entenderse como producción audiovisual, es pertinente tener en cuenta los conceptos fundamentales de la escritura creativa y la producción audiovisual que puedan ser más aportantes al proceso de elaboración de proyectos de innovación

Retos del derecho constitucional contemporáneo

1 documento en PDF de 16 páginas.Con reflexiones académicas sobre el “neoconstitucionalismo”, este libro recoge conclusiones de la experiencia constitucional en Colombiay en otros países. Especialmente crítico, destaca los aciertos del neoconstitucionalismo y plantea cómo este ha sido incapaz de fortalecer la justicia y de modelar una sociedad más incluyente, por lo cual los autores recomiendan una revisión profunda de sus tesis principales y retomar las fuentes propias de la juridicidad humana y la universalidad de sus bienes básicos y fundamentales.PRESENTACIÓN CAPÍTULO PRIMERO LA CORTE CONSTITUCIONAL ANTE EL TRIBUNAL DE LA HISTORIA 1. Introducción 2. El "núcleo puro y duro de la Constitución de 1991" 3. "Yo doy las órdenes". La ingeniería social de la Corte Constitucional de Colombia 4. Constitución y Corte Constitucional: una misma cosa 5. Nuevamente el "deseo" como fundamento de la juridicidad: un juez que dice mentiras 6. A modo de conclusión: los poderosos también caen CAPÍTULO II LOS DERECHOS HUMANOS. ¿ENTRE DESEOS PARTICULARES Y BIENES FUNDAMENTALES? 7. La sociedad secularizada 8. Las "lisonjas de los bribones" 9. De Protágoras a Rorty 10. Rawls, Nozick, Hume, Constant 11. Pluralismo sin fundamentalismos 12. El riesgo del "mandarinismo" 13. El juez constitucional. ¿Imparcial e independiente? 14. El riesgo de la manipulación ideológica del derecho 15. Algunos rasgos del nuevo constitucionalismo 16. ¿Oligarquías del fundamentalismo secularista? 17. ¿Magistratura al servicio de la justicia o al servicio de intereses? 18. Opinión pública y limitación del poder 19. Epílogo. El ojo independiente de la sociedad y los pequeños pelotones CAPÍTULO III POSITIVISMO, NEOCONSTITUCIONALISMO Y ACTIVISMO JUDICIAL 20. Preliminares A) EL POSITIVISMO JURÍDICO DE HANS KELSEN 21. Autointerés y conflicto 22. La norma 23. Activismo judicial 24. Conclusión. Dominación ilegal y tiranía B) NEOCONSTITUCIONALISMO 25. El sujeto de derechos y la despolitización de la convivencia 26. Los derechos 27. Activismo judicial 28. Estado de naturaleza y anarquismo 29. Consideraciones finales CAPÍTULO IV LAS APORÍAS PRESENTES DEL DERECHO CONSTITUCIONAL 30. Constitución, derecho constitucional y constitucionalismo 31. Constitucionalismo, derecho público y derecho privado 32. Constitución del Estado y constructivismo social 33. ¿Separación de poderes? 34. Un escolio sobre el "judicialismo" 35. El funcionalismo federalista 36. Constitucionalismo y personalismo 37. Neo y posconstitucionalismo CAPÍTULO V DEL LAICISMO A LA LAICIDAD. UNAS REFLEXIONES (NO EXCLUSIVAMENTE) ESPAÑOLAS 38. ¿De nominibus non est disputandum?" o "res denominatur a potiori?" 39. Al principio, "non est potestas nisi a Deo" 40. El Estado moderno y sus transformaciones. La puesta en plural del pecado original y la doctrina social de la Iglesia como contestación cristiana del mundo moderno 41. La ruina espiritual de un pueblo por efecto de una política 42. Las incoherencias de la predicación actual y la reedificación del derecho público cristiano CAPÍTULO VI LAS RELACIONES ENTRE RELIGIÓN Y POLÍTICA EN LA SOCIEDAD POSTSECULAR DEL SIGLO XXI 43. Presentación 44. La política 45. La religión 46. Las relaciones entre política y religión 47. La actual trascendencia social, cultural y política del fenómeno religioso 48. El debate Habermas - Ratzinger y el advenimiento de la llamada sociedad postsecular CAPÍTULO VII EL CONSTITUCIONALISMO FRENTE A LAS CONSTITUCIONES CONTEMPORÁNEAS 49. Introducción 50. El concepto de Constitución 51. La clasificación de las constituciones y una mirada realista 52. La necesidad de "desestatizar" las fuentes del derecho constitucional 53. Una evaluación del principio de separación de poderes 54. La diferencia entre el mundo del "rule of law" y del Estado de derecho 55. El nacimiento del control de constitucionalidad 56. La tradición constitucional en el reconocimiento de los derechos y libertades 57. Las garantías y su progresiva fragmentación en los textos constitucionales 58. El dimensionamiento de una Constitución 59. Las llamadas constituciones modernas 60. Las nuevas tendencias constitucionales 61. Conclusión. El ejemplo constitucional anglosajón CAPÍTULO VIII LA TEORÍA DE LOS PRINCIPIOS Y EL ESTADO CONSTITUCIONAL. LUCES Y SOMBRAS 62. El Estado constitucional y los principios jurídico-constitucionales 63. La teoría de los principios en la teoría contemporánea del derecho 64. Principios jurídicos y valores constitucionales 65. Criterios distintivos entre principios y reglas 66. La cuestión del fundamento de los principios. Una asignatura pendiente en la teoría principalista de los derechos CAPÍTULO IX EL CONTROL DE CONSTITUCIONALIDAD DE REFORMAS CONSTITUCIONALES. ALGUNAS SALIDAS PARA LA ENCRUCIJADA CONTRAMAYORITARIA 67. Introducción 68. Las sombras del control de reformas por sustitución 69. Algunas salidas 70. La aplicabilidad de estas alternativas al caso colombiano BIBLIOGRAFÍ

Método de planeamiento de osteotomías alrededor de la rodilla en el plano coronal

L Las deformidades angulares de los miembros inferiores en el plano coronal son una alteración en la alineación causada por la pérdida de colinealidad de la cadera, rodilla y el tobillo, y se caracterizan por producir sobrecarga más allá de lo tolerable en cada uno de los compartimentos femorotibiales. Las osteotomías son procedimientos quirúrgicos que tratan estas deformidades, principalmente, retirando carga de un compartimento enfermo a uno más sano, dando una terapia puente antes de realizar un reemplazo articular. En las últimas décadas se han popularizado ofreciendo un manejo para los pacientes jóvenes y activos para los cuales la indicación quirúrgica no es la artroplastia. El éxito de la osteotomía depende de un adecuado planeamiento, el que inicia desde encontrar al paciente ideal y que esté dentro de las indicaciones. El uso de la radiografía panorámica, y la evaluación de las diferentes medidas que podemos obtener de esta imagen, nos lleva a identificar el origen de la deformidad, el grado de corrección que amerita para tener un balance articular adecuado y a planear dónde se debe realizar la osteotomía, incluido exactamente lo que se debe hacer en la cirugía para obtener resultados esperados. El objetivo del presente trabajo es describir un método preciso, reproducible y al alcance del cirujano para un adecuado planeamiento y un resultado postoperatorio exitoso

Guía de práctica clínica para el diagnóstico, tratamiento y seguimiento de los pacientes mayores de 15 años diabetes mellitus tipo 1

La diabetes mellitus tipo 1 es una enfermedad que suele aparecer tempranamente, implicando que los pacientes convivan con ella por muchos años. Del adecuado control clínico que se logre, dependerán los resultados y como se trata de una condición con potenciales complicaciones serias, es imperativo tener claridad sobre su diagnóstico, tratamiento y seguimiento para minimizar impacto en morbilidad, calidad de vida y mortalidad.Pacientes mayores de 15 añoshttps://orcid.org/0000-0003-0960-9480https://orcid.org/0000-0002-1982-6799https://orcid.org/0000-0002-9013-5384N/

Monetary Policy Report - July de 2021

Macroeconomic summary The Colombian economy sustained numerous shocks in the second quarter, pri¬marily related to costs and supply. The majority of these shocks were unantic¬ipated or proved more persistent than expected, interrupting the recovery in economic activity observed at the beginning of the year and pushing overall inflation above the target. Core inflation (excluding food and regulated items) increased but remained low, in line with the technical staff’s expectations. A third wave of the pandemic, which became more severe and prolonged than the previous outbreak, began in early April. This had both a high cost in terms of human life and a negative impact on Colombia's economic recovery. Between May and mid-June roadblocks and other disruptions to public order had a sig¬nificant negative effect on economic activity and inflation. The combination and magnitude of these two shocks likely led to a decline in gross domestic product (GDP) compared to the first quarter. Roadblocks also led to a significant in¬crease in food prices. The accumulated effects of global disruptions to certain value chains and increased international freight transportation prices, which since the end of 2020 have restricted supply and increased costs, also affected Colombia’s economy. The factors described above, which primarily affected the consumer price index (CPI) for goods and foods, explain to a significant degree the technical staff’s forecast errors and the increase in overall inflation above the 3% target. By contrast, increases in core inflation and in prices for regulated items were in line with the technical staff’s expectations, and can be explained largely by the elimination of various price relief measures put in place last year. An increase in perceived sovereign risk and the upward pressures that this im¬plies on international financing costs and the exchange rate were further con¬siderations. Despite significant negative shocks, economic growth in the first half of the year (9.1%) is now expected to be significantly higher than projected in the April re¬port (7.1%), a sign of a more dynamic economy that could recover more quickly than previously forecast. Diverse economic activity figures have indicated high¬er-than-expected growth since the end of 2020. This suggests that the negative effects on output from recurring waves of COVID-19 have grown weaker and less long-lasting with subsequent outbreaks. Nevertheless, the third wave of the coro¬navirus, and to an even greater degree the previously mentioned roadblocks and disruptions to public order, likely led to a decline in GDP in the second quar¬ter compared to the first. Despite this, data from the monthly economic tracking indicator (ISE) for April and May surpassed expectations, and new sector-level measures of economic activity suggest that the negative impact of the pandemic on output continues to moderate, amid reduced restrictions on mobility and im¬provements in the pace of vaccination programs. Freight transportation registers (June) and unregulated energy demand (July), among other indicators, suggest a significant recovery following the roadblocks in May. Given the above, annual GDP growth in the second quarter is expected to have been around 17.3% (previously 15.8%), explained in large part by a low basis of comparison. The technical staff revised its growth projection for 2021 upward from 6% to 7.5%. This forecast, which comes with an unusually high degree of uncertain¬ty, assumes no additional disruptions to public order and that any new waves of COVID-19 will not have significant additional negative effects on economic activity. Recovery in international demand, price levels for some of Colombia’s export com¬modities, and remittances from workers abroad have all performed better than projected in the previous report. This dynamic is expected to continue to drive recovery in the national income over the rest of the year. Continued ample international liquidity, an acceleration in vacci¬nation programs, and low interest rates can also be ex¬pected to favor economic activity. Improved performance in the second quarter, which led to an upward growth revision for all components of spending, is expected to continue, with the economy returning to 2019 production levels at the end of 2021, earlier than estimated in the April report. This forecast continues to account for the short-term effects on aggregate demand of a tax reform package along the lines of what is currently being pro-posed by the national government. Given the above, the central forecast scenario in this report projects growth in 2021 of 7.5% and in 2022 of 3.1% (Graph 1.1). In this scenar¬io, economic activity would nonetheless remain below potential. The noted improvement in these projections comes with a high degree of uncertainty. Annual inflation increased more than expected in June (3.63%) as a result of changes in food prices, while growth in core inflation (1.87%) was similar to projections. The in¬creased CPI for foods would be expected to persist for the remainder of the year, contributing to inflation remaining above the target. Overall and core inflation would be ex¬pected to return to close to 3% at the end of 2022, amid a deceleration in growth in the CPI for foods and reduced ex¬cess productive capacity. Recent increases in international freight and agricultural goods prices, as well as the live¬stock cycle and increased meat exports, have exerted up¬ward pressure on food prices, primarily in processed foods (see Box 21). In addition to these persistent factors affecting prices, national roadblocks and related disruptions to pub¬lic order in several cities throughout May and parts of June were reflected in a significant restriction of supply and an unexpected annual increase in the CPI for foods (8.52%). Inflation in regulated items (5.93%) also accelerated, due to a low basis of comparison on gasoline prices and the par¬tial lapse of relief measures on utility rates that were put in place in 2020. Inflation excluding food and regulated items recovered in line with projections to 1.87%, due to the rein¬statement of indirect taxes on certain goods and services that had been temporarily eliminated in 2020, and to up¬ward pressures exerted by prices for foods away from home (FAH), among other factors. The increase in perishable foods prices is expected to be reversed over the course of the year, assuming an absence of additional, long-lasting blockades of national roads. Increased processed food pric¬es would be expected to persist and contribute to keeping inflation above the target at the end of the year. Inflation excluding foods and regulated items is expected to contin¬ue to exhibit an upward trend, as excesses in productive ca¬pacity continue to close, and register a temporary increase in March 2022 largely due to the reinstatement of the FAH consumption tax. Given the above, overall year-end infla¬tion is expected to be 4.1% in 2021 and 3.1% in 2022 (Graph 1.2), and core inflation is expected to be 2.6% in 2021 and 3.2% in 2022 (Graph 1.3). The technical staff has interpreted the overall behavior of prices in the CPI excluding food and regulated items, alongside continued unexpected increases in economic activity, as signs of more ample excess productive capaci¬ty in the economy. This would be expected to persist over the next two years, with the output gap closing at the end of that period. Increased economic growth suggests a less negative output gap than estimated last quarter. Nevertheless, the behavior of core inflation, especially in services, suggests that potential GDP has recovered to an unanticipated degree and that ample excess capacity con¬tinues, with a persistent effect on aggregate demand. La¬bor market observation supports this interpretation, with persistent high levels of unemployment and stagnation in the recovery of jobs lost as a result of the pandemic. Increased inflation can be explained largely by shocks re¬lated to costs and supply, and by the dissolution of some price relief measures put in place in 2020. The growth and inflation forecasts described above would be consistent with a less negative output gap closing more quickly across the forecast horizon compared to the projection from the April report. Nevertheless, uncertainty surrounding excess capacity is very high and constitutes a risk to the forecast (Graphic 1.4). The fiscal accounts outlook deteriorated, Standard and Poor’s Global Ratings (S&P) and Fitch Ratings (Fitch) down¬graded Colombia’s credit rating, roadblocks and disrup¬tions to public order affected output, and the country faced a third wave of COVID-19 that was more severe and prolonged than the previous outbreak. These factors were reflected in an increased risk premium and depreciation of the peso compared to the dollar. This occurred in a favor¬able context in regard to foreign income, as international prices for oil, coffee, and other Colombian export goods in¬creased. This contributed to a recovery in the terms of trade and in the national income and mitigated upward pres¬sures on the risk premium and the exchange rate. Expected oil prices in this report are USD 68 per barrel (previous¬ly USD 61/bl) for 2021 and USD 66/bl (previously USD 60/ bl) for 2022. This increased trajectory shows convergence to oil prices below recently observed levels, as a result of increased global supply that would more than offset increased demand. As a result, the recent price increase is expected to be temporary. International financial conditions are expected to become somewhat less fa¬vorable in the current macroeconomic context, despite the improvement in foreign income due to increased demand and some higher prices for oil and other export products. Growth in foreign demand was better than expected in the previous report, with projections for 2021 and 2022 increasing from 5.2% to 6.0% and from 3.4% to 3.5%, respectively. For the year to date, figures for economic activity suggest more dynamic foreign demand than previously expected. Output recovery has been faster in the United States and China than in Latin America, as economic reactivation in the latter has been limit¬ed by outbreaks of COVID-19, restricted vaccine supplies, and a lack of fiscal space to confront the pandemic, among other factors. The positive dynamic in foreign goods trade has come amid a deterioration in value chains and a significant increase in commodities and freight prices (see Box 3). Inflation in the United States has been unexpectedly high, with observed and expected values remaining above the target, while growth forecasts have been revised upward. As a result, the beginning of a normalization in monetary policy in the U.S. could come earlier than previously projected. This report estimates that the U.S. Federal Reserve’s first rate increase will come at the end of 2022 (before the first quarter of 2023). Colombia’s risk premium is projected to be higher than forecast in the April report, and is expected to remain on a growth trajectory given the country’s accumulation of public and external debt. This would be expected to contribute to an increase in international financing costs on the forecast horizon. An expansionary monetary policy stance continues to support favorable do¬mestic financing conditions. The interbank rate and the reference banking indi¬cator (IBR)remained consistent with the policy interest rate in the second quar¬ter. Average deposit and credit rates continued at historical lows, despite some observed increases at the end of June. The peso-denominated credit portfolio continued to decelerate in annual terms and, between March and June, growth in the household credit portfolio accelerated, primarily related to housing pur¬chases. Disbursements and recovery in the commercial credit portfolio were significant, returning to high levels observed one year ago, when businesses required significant levels of liquidity to confront the economic effects of the pandemic. Meanwhile, credit risk increased, liability provisions remained high, and some banks withdrew from the balance of their past-due portfolios. Nev¬ertheless, financial system earnings have recovered, and liquidity and solvency levels remain above regulatory minimums. Beginning with this report, a new methodology will be used to quantify and communicate the uncertainty surrounding central macroeconomic fore¬casts in the context of an active monetary policy. The new methodology, known as predictive densities (PD), will be explained in detail in Box 1. PD methodology provides probability distributions of the main forecast vari¬ables (e.g. growth, inflation) based on the balance of risks of key factors that, in the technical staff’s judgment, could affect the economy on the forecast horizon. These distributions reflect the result of possible shocks (to external variables, prices, and economic activity) that the economy could sustain and the transmission effects considering Colombia’s economic structure and anticipated monetary policy responses. As a result, PD allows for the quantification of uncertainty around the central forecast and of its bias. In this report, the PD exercise shows a downward bias for both economic growth and output gap, while the op¬posite is shown for headline inflation (Graphs 1.1, 1.2 and 1.3). The balance of risks indicates more complex mone¬tary policy dilemmas than previously expected. The most significant anticipated risk regarding external financing would be a return to less favorable conditions in a sce¬nario in which the U.S. Federal Reserve promptly raises interest rates. Such a decision could come as the result of current levels of economic growth and higher-than-ex¬pected employment generating significant inflationary pressures on that country. Uncertainty regarding Colom¬bia’s fiscal outlook and the subsequent effects on the risk premium and external financing costs represent addi¬tional considerations. The risks to economic growth are mainly downside risks, relating especially to the effects of political and fiscal uncertainty on consumption and investment decisions and the potential for additional waves of COVID-19 and the subsequent effects on eco-nomic activity. Inflation risks take into account the po¬tential for more persistent shocks associated with dis¬ruption to value chains, higher international commodity and food prices, and a slower-than-expected recovery in the national agricultural chain as a result of the recent roadblocks. These would represent upward risks primarily to food and goods prices. The main downside risk to the inflation forecast would come from an increase in rental housing prices below the central scenario projection. This would be explained by weak demand and increased sup¬ply in 2022 as a result of high observed housing sales this year. All told, the PD exercise reveals a downward bias for economic growth forecast, with 90% probability of growth between 6.1% and 9.1% for 2021 and between 0.5% and 4.1% in 2022. The output gap also exhibits a downward bias to the central forecast scenario, primarily in 2022. On the contrary, an upward bias is expected for headline inflation forecast, with 90% probability ranging between 3.7% and 4.9% in 2021 and between 2.2% and 4.7% in 2022. 1.2 Monetary policy decision In its meetings in June and July the BDBR left the bench¬mark interest rate unchanged at 1.75% (Graph 1.5).Box 1. Characterizing and Communicating the Balance of Risks of Macroeconomic Forecasts: A Predictive Densities Approach for Colombia Authors: Juan Camilo Méndez-Vizcaíno, César Ánzola-Bravo, Alexander Guarín y Anderson Grajales-OlarteBox 2. Analysis of Recent Disturbances in Global Logistics Chains and their Impact on Colombian Import Markets. Authors: Aarón Garavito, Juan Diego Cortés, Stefany Andrea Moreno, Alex Fernando Pérez y Juan Esteban CarranzaBox 3. The Upward Dynamics of Food Prices. Authors: Edgar Caicedo G., Andrea Salazar D. y Jesús Daniel Sarmiento S

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Proyecto Ensamblando en Colombia

Los dos volúmenes de esta obra reúnen los resultados del proyecto ganador de la «Convocatoria nacional de proyectos bicentenario 1810-2010 “Historia social de la ciencia, la tecnología y la innovación en Colombia: ciudadanía, saberes y nación”», lanzada por Colciencias en el 2009. El proyecto, titulado «Ensamblado en Colombia: producción de saberes y construcción de ciudadanías» se propuso estudiar la manera como se constituyen en el presente y se han constituido en el pasado «asuntos de interés público» que tienen una clara dimensión epistémica y ontológica, pues la producción de saberes nos interpela y convoca como académicos y como ciudadanos, como académicas y como ciudadanas. Se trata de comprender cómo se ensamblan saberes, naturalezas, tecnologías y ciudadanías y de ensayar diálogos de estilos, enfoques y miradas que reconozcan la alteridad, la multiplicidad y la heteroglosia como partes esenciales en y para la producción simultánea de conocimiento y formas de sociedad

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication