Satisfacción de los usuarios sobre la calidad de atención recibida en el servicio de hemodiálisis. Hospital Militar Escuela DR. Alejandro Dávila Bolaños, Managua, Nicaragua, Marzo – Abril 2019

Estudio descriptivo de corte transversal. La muestra y el Universo estuvo constituida por 101 usuarios, las variables por objetivos características sociodemográficas y las 5 dimensiones de la encuesta SERVQUAL. Fuente de información primaria. La información se recolectó por 2 Licenciadas en Enfermería. El procesamiento de la información se realizó en Open Data Kit (ODK). Se realizaron 101 encuestas, de las cuales, se observó que hubo un equilibrio en las cuatro categorías de edades una población activa laboralmente y llegando a la adultez el 54.45% fueron Hombres, el 37.6% son bachilleres y universitarias 26.7% y el 77.2% procedentes del área urbana. Las brechas por dimensión fueron las siguientes: Bienes Tangibles 0.03, Confiabilidad -0.03, Responsabilidad 0.01, Seguridad 0.04, Empatía -0.16. El índice de calidad del servicio fue -0.02. Al clasificar la calidad del servicio, la dimensión con la brecha más alejada de cero, fue la confiabilidad y las más cercana de cero fueron seguridad seguidos por los bienes tangibles; el resultado del índice de calidad del servicio (ICS) se interpreta como que el servicio brindado por hemodiálisis, según las percepciones y expectativas, cumplen moderadamente con el estándar de calida

Micobiota de plantas donadoras y hongos filamentosos contaminantes del establecimiento in vitro de cinco especies forestales

Although protocols to propagate large numbers of woody species by in vitro culture have been developed, microbial contamination of explants is a fundamental problem which limits its application. The objectives of this study were: to identify the donor plant mycobiota and to identify filamentous fungi contaminants at the establishment phase of mahogany, teak, majagua, pine and cedar. Explants of donor plants were placed in moist chamber and were prepared to direct optical microscope of fungal growth. Cultural characteristics and morphological were taken into account to identify filamentous fungi contaminants in the establishment phase. Frequency of all genera identified was determined. Eleven genera of filamentous fungi in donor plants and twenty genera in the establishment of forest species were identified. The genera Botryodiplodia, Cephalosporium, Diplodia, Dreschlera, Geotrichum, Gloeosporium Helminthosporium, Memnoniella, Oidiodendron and Rhinoclediella appeared only during establishment phase. Others such as Alternaria, Aspergillus, Cercospora, Curvularia, Cladosporium, Colletotricum, Fusarium, Nigrospora, Penicillium and Pestalotia were detected in donor plants and during establishment phase. This indicates that the possible source of contamination was the initial explant. The most frequent genera were Botryodiplodia in teak, Nigrospora in majagua and Alternaria in pine, cedar and mahogany. A phytosanitary plan of defence for donor plants was developed. The plan included systemic and contact fungicides whose spectrum of activity covered the identified genera of fungi.Keywords: cedar, mahogany, majagua, micropropagation, microbial contamination, pine, teakA pesar de que se han desarrollado protocolos para propagar un gran número de especies forestales por cultivo in vitro, la contaminación fúngica de los explantes constituye uno de los problemas fundamentales que limita su aplicación. Los objetivos de este trabajo fueron identificar la micobiota de plantas donadoras y los hongos filamentosos contaminantes del establecimiento in vitro de explantes de cinco especies forestales (caoba, teca, majagua, pino y cedro). De plantas donadoras se tomaron explantes que se colocaron en cámara húmeda. Se realizaron preparaciones directas al microscopio óptico del crecimiento fúngico, se aislaron e identificaron los géneros presentes. Además, se aislaron e identificaron los hongos filamentosos contaminantes de la fase de establecimiento. Se identificaron 11 géneros fúngicos presentes en las plantas donadoras y 20 como contaminantes del establecimiento in vitro. Botryodiplodia, Cephalosporium, Diplodia, Dreschlera, Geotrichum, Gloeosporium Helminthosporium, Memnoniella, Oidiodendron y Rhinoclediella aparecieron solamente durante la fase de establecimiento, mientras que Alternaria, Aspergillus, Cercospora, Curvularia, Cladosporium, Colletotricum, Fusarium, Nigrospora, Penicillium y Pestalotia se detectaron en plantas donadoras y durante la fase de establecimiento, lo que indicó que el explante inicial fue la posible fuente de contaminación. Los géneros más frecuentes fueron Botryodiplodia en teca, Nigrospora en majagua y Alternaria en pino, cedro y caoba. A partir de estos resultados se elaboró un plan de defensa fitosanitario para plantas donadoras que incluyó fungicidas sistémicos y de contacto cuyo espectro de acción cubría los géneros de hongos identificados.Palabras clave: caoba, cedro, contaminación microbiana, majagua, micropropagación, pino, tec

Fats and Oils from Diet: Considerations for its Consumption in Colombian Population

El 78 % de las muertes ocurridas en Colombia en 2019 se debieron a enfermedades crónicas no transmisibles. De estas, el 30 % se originaron por condiciones cardiovasculares que se explican principalmente por factores de riesgo como sedentarismo, tabaquismo y patrones de alimentación no saludables. El exceso de consumo de grasas provenientes de la dieta, especialmente saturadas y trans, está relacionado con diversos efectos negativos en salud. En la población colombiana, la ingesta de grasas está dada principalmente por el uso de aceites empleados en frituras y el consumo de productos comestibles ultraprocesados. La Ley 2120, aprobada en Colombia, establece la implementación de un sistema de etiquetado nutricional de advertencia de los principales nutrientes críticos, dentro de ellos de las grasas no saludables contenidas en exceso en comestibles envasados.Q4Población colombianaIn Colombia, 78% of deaths in 2019 were caused bynoncommunicable diseases. Around 30% correspond tocardiovascular causes. This is a multifactorial problem,involving a sedentary lifestyle, smoking, and unhealthyeating habits. The surplus of fat consumption, especiallysaturated and trans fats, is related to various negativeimpacts on health. In the Colombian population, theintake of fats is mainly originated from oils employed infried cooking and ultra-processed products. The 2120 law,recently passed in the Colombian Congress, enforces thelabeling of packaged products, informing about criticalnutrients, including unhealthy fats contained in consumerpackaged goods.https://orcid.org/0000-0001-5141-5052https://orcid.org/0000-0003-4102-3893https://orcid.org/0000-0002-3987-312Xhttps://orcid.org/0000-0003-2619-1266https://orcid.org/0000-0002-2934-1541https://orcid.org/0000-0002-0870-6759https://orcid.org/0000-0002-0998-0821https://orcid.org/0000-0003-4161-8555https://orcid.org/0000-0001-5650-8610https://orcid.org/0000-0001-7716-356Xhttps://orcid.org/0000-0003-0283-794Xhttps://orcid.org/0000-0001-5780-9247https://orcid.org/0000-0001-5396-8726https://orcid.org/0000-0003-1834-3012Revista Nacional - IndexadaS

First Latin American clinical practice guidelines for the treatment of systemic lupus erythematosus: Latin American Group for the Study of Lupus (GLADEL, Grupo Latino Americano de Estudio del Lupus)-Pan-American League of Associations of Rheumatology (PANLAR)

Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016. They selected a list of questions for the clinical problems most commonly seen in Latin American patients with SLE. These were addressed with the best available evidence and summarised in a standardised format following the Grading of Recommendations Assessment, Development and Evaluation approach. All preliminary findings were discussed in a second face-to-face meeting in Washington, DC, in November 2016. As a result, nine organ/system sections are presented with the main findings; an 'overarching' treatment approach was added. Special emphasis was made on regional implementation issues. Best pharmacologic options were examined for musculoskeletal, mucocutaneous, kidney, cardiac, pulmonary, neuropsychiatric, haematological manifestations and the antiphospholipid syndrome. The roles of main therapeutic options (ie, glucocorticoids, antimalarials, immunosuppressant agents, therapeutic plasma exchange, belimumab, rituximab, abatacept, low-dose aspirin and anticoagulants) were summarised in each section. In all cases, benefits and harms, certainty of the evidence, values and preferences, feasibility, acceptability and equity issues were considered to produce a recommendation with special focus on ethnic and socioeconomic aspects. Guidelines for Latin American patients with lupus have been developed and could be used in similar settings.Fil: Pons Estel, Bernardo A.. Centro Regional de Enfermedades Autoinmunes y Reumáticas; ArgentinaFil: Bonfa, Eloisa. Universidade de Sao Paulo; BrasilFil: Soriano, Enrique R.. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Cardiel, Mario H.. Centro de Investigación Clínica de Morelia; MéxicoFil: Izcovich, Ariel. Hospital Alemán; ArgentinaFil: Popoff, Federico. Hospital Aleman; ArgentinaFil: Criniti, Juan M.. Hospital Alemán; ArgentinaFil: Vásquez, Gloria. Universidad de Antioquia; ColombiaFil: Massardo, Loreto. Universidad San Sebastián; ChileFil: Duarte, Margarita. Hospital de Clínicas; ParaguayFil: Barile Fabris, Leonor A.. Hospital Angeles del Pedregal; MéxicoFil: García, Mercedes A.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Amigo, Mary Carmen. Centro Médico Abc; MéxicoFil: Espada, Graciela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; ArgentinaFil: Catoggio, Luis J.. Hospital Italiano. Instituto Universitario. Escuela de Medicina; ArgentinaFil: Sato, Emilia Inoue. Universidade Federal de Sao Paulo; BrasilFil: Levy, Roger A.. Universidade do Estado de Rio do Janeiro; BrasilFil: Acevedo Vásquez, Eduardo M.. Universidad Nacional Mayor de San Marcos; PerúFil: Chacón Díaz, Rosa. Policlínica Méndez Gimón; VenezuelaFil: Galarza Maldonado, Claudio M.. Corporación Médica Monte Sinaí; EcuadorFil: Iglesias Gamarra, Antonio J.. Universidad Nacional de Colombia; ColombiaFil: Molina, José Fernando. Centro Integral de Reumatología; ColombiaFil: Neira, Oscar. Universidad de Chile; ChileFil: Silva, Clóvis A.. Universidade de Sao Paulo; BrasilFil: Vargas Peña, Andrea. Hospital Pasteur Montevideo; UruguayFil: Gómez Puerta, José A.. Hospital Clinic Barcelona; EspañaFil: Scolnik, Marina. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Pons Estel, Guillermo J.. Centro Regional de Enfermedades Autoinmunes y Reumáticas; Argentina. Hospital Provincial de Rosario; ArgentinaFil: Ugolini Lopes, Michelle R.. Universidade de Sao Paulo; BrasilFil: Savio, Verónica. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Drenkard, Cristina. University of Emory; Estados UnidosFil: Alvarellos, Alejandro J.. Hospital Privado Universitario de Córdoba; ArgentinaFil: Ugarte Gil, Manuel F.. Universidad Cientifica del Sur; Perú. Hospital Nacional Guillermo Almenara Irigoyen; PerúFil: Babini, Alejandra. Instituto Universitario Hospital Italiano de Buenos Aires. Rectorado.; ArgentinaFil: Cavalcanti, André. Universidade Federal de Pernambuco; BrasilFil: Cardoso Linhares, Fernanda Athayde. Hospital Pasteur Montevideo; UruguayFil: Haye Salinas, Maria Jezabel. Hospital Privado Universitario de Córdoba; ArgentinaFil: Fuentes Silva, Yurilis J.. Universidad de Oriente - Núcleo Bolívar; VenezuelaFil: Montandon De Oliveira E Silva, Ana Carolina. Universidade Federal de Goiás; BrasilFil: Eraso Garnica, Ruth M.. Universidad de Antioquia; ColombiaFil: Herrera Uribe, Sebastián. Hospital General de Medellin Luz Castro de Gutiérrez; ColombiaFil: Gómez Martín, DIana. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Robaina Sevrini, Ricardo. Universidad de la República; UruguayFil: Quintana, Rosana M.. Hospital Provincial de Rosario; Argentina. Centro Regional de Enfermedades Autoinmunes y Reumáticas; ArgentinaFil: Gordon, Sergio. Hospital Interzonal General de Agudos Dr Oscar Alende. Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas; ArgentinaFil: Fragoso Loyo, Hilda. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Rosario, Violeta. Hospital Docente Padre Billini; República DominicanaFil: Saurit, Verónica. Hospital Privado Universitario de Córdoba; ArgentinaFil: Appenzeller, Simone. Universidade Estadual de Campinas; BrasilFil: Dos Reis Neto, Edgard Torres. Universidade Federal de Sao Paulo; BrasilFil: Cieza, Jorge. Hospital Nacional Edgardo Rebagliati Martins; PerúFil: González Naranjo, Luis A.. Universidad de Antioquia; ColombiaFil: González Bello, Yelitza C.. Ceibac; MéxicoFil: Collado, María Victoria. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Sarano, Judith. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Retamozo, Maria Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto de Investigaciones en Ciencias de la Salud. Universidad Nacional de Córdoba. Instituto de Investigaciones en Ciencias de la Salud; ArgentinaFil: Sattler, María E.. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Gamboa Cárdenas, Rocio V.. Hospital Nacional Guillermo Almenara Irigoyen; PerúFil: Cairoli, Ernesto. Universidad de la República; UruguayFil: Conti, Silvana M.. Hospital Provincial de Rosario; ArgentinaFil: Amezcua Guerra, Luis M.. Instituto Nacional de Cardiologia Ignacio Chavez; MéxicoFil: Silveira, Luis H.. Instituto Nacional de Cardiologia Ignacio Chavez; MéxicoFil: Borba, Eduardo F.. Universidade de Sao Paulo; BrasilFil: Pera, Mariana A.. Hospital Interzonal General de Agudos General San Martín; ArgentinaFil: Alba Moreyra, Paula B.. Universidad Nacional de Córdoba. Facultad de Medicina; ArgentinaFil: Arturi, Valeria. Hospital Interzonal General de Agudos General San Martín; ArgentinaFil: Berbotto, Guillermo A.. Provincia de Buenos Aires. Ministerio de Salud. Hospital Interzonal de Agudos "Eva Perón"; ArgentinaFil: Gerling, Cristian. Hospital Interzonal General de Agudos Dr Oscar Alende. Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas; ArgentinaFil: Gobbi, Carla Andrea. Universidad Nacional de Córdoba. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Gervasoni, Viviana L.. Hospital Provincial de Rosario; ArgentinaFil: Scherbarth, Hugo R.. Hospital Interzonal General de Agudos Dr Oscar Alende. Unidad de Reumatología y Enfermedades Autoinmunes Sistémicas; ArgentinaFil: Brenol, João C. Tavares. Hospital de Clinicas de Porto Alegre; BrasilFil: Cavalcanti, Fernando. Universidade Federal de Pernambuco; BrasilFil: Costallat, Lilian T. Lavras. Universidade Estadual de Campinas; BrasilFil: Da Silva, Nilzio A.. Universidade Federal de Goiás; BrasilFil: Monticielo, Odirlei A.. Hospital de Clinicas de Porto Alegre; BrasilFil: Seguro, Luciana Parente Costa. Universidade de Sao Paulo; BrasilFil: Xavier, Ricardo M.. Hospital de Clinicas de Porto Alegre; BrasilFil: Llanos, Carolina. Universidad Católica de Chile; ChileFil: Montúfar Guardado, Rubén A.. Instituto Salvadoreño de la Seguridad Social; El SalvadorFil: Garcia De La Torre, Ignacio. Hospital General de Occidente; MéxicoFil: Pineda, Carlos. Instituto Nacional de Rehabilitación; MéxicoFil: Portela Hernández, Margarita. Umae Hospital de Especialidades Centro Medico Nacional Siglo Xxi; MéxicoFil: Danza, Alvaro. Hospital Pasteur Montevideo; UruguayFil: Guibert Toledano, Marlene. Medical-surgical Research Center; CubaFil: Reyes, Gil Llerena. Medical-surgical Research Center; CubaFil: Acosta Colman, Maria Isabel. Hospital de Clínicas; ParaguayFil: Aquino, Alicia M.. Hospital de Clínicas; ParaguayFil: Mora Trujillo, Claudia S.. Hospital Nacional Edgardo Rebagliati Martins; PerúFil: Muñoz Louis, Roberto. Hospital Docente Padre Billini; República DominicanaFil: García Valladares, Ignacio. Centro de Estudios de Investigación Básica y Clínica; MéxicoFil: Orozco, María Celeste. Instituto de Rehabilitación Psicofísica; ArgentinaFil: Burgos, Paula I.. Pontificia Universidad Católica de Chile; ChileFil: Betancur, Graciela V.. Instituto de Rehabilitación Psicofísica; ArgentinaFil: Alarcón, Graciela S.. Universidad Peruana Cayetano Heredia; Perú. University of Alabama at Birmingahm; Estados Unido

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Impacts of the Tropical Pacific/Indian Oceans on the Seasonal Cycle of the West African Monsoon

The current consensus is that drought has developed in the Sahel during the second half of the twentieth century as a result of remote effects of oceanic anomalies amplified by local land–atmosphere interactions. This paper focuses on the impacts of oceanic anomalies upon West African climate and specifically aims to identify those from SST anomalies in the Pacific/Indian Oceans during spring and summer seasons, when they were significant. Idealized sensitivity experiments are performed with four atmospheric general circulation models (AGCMs). The prescribed SST patterns used in the AGCMs are based on the leading mode of covariability between SST anomalies over the Pacific/Indian Oceans and summer rainfall over West Africa. The results show that such oceanic anomalies in the Pacific/Indian Ocean lead to a northward shift of an anomalous dry belt from the Gulf of Guinea to the Sahel as the season advances. In the Sahel, the magnitude of rainfall anomalies is comparable to that obtained by other authors using SST anomalies confined to the proximity of the Atlantic Ocean. The mechanism connecting the Pacific/Indian SST anomalies with West African rainfall has a strong seasonal cycle. In spring (May and June), anomalous subsidence develops over both the Maritime Continent and the equatorial Atlantic in response to the enhanced equatorial heating. Precipitation increases over continental West Africa in association with stronger zonal convergence of moisture. In addition, precipitation decreases over the Gulf of Guinea. During the monsoon peak (July and August), the SST anomalies move westward over the equatorial Pacific and the two regions where subsidence occurred earlier in the seasons merge over West Africa. The monsoon weakens and rainfall decreases over the Sahel, especially in August.Peer reviewe

Search for heavy resonances decaying to two Higgs bosons in final states containing four b quarks

A search is presented for narrow heavy resonances X decaying into pairs of Higgs bosons (H) in proton-proton collisions collected by the CMS experiment at the LHC at root s = 8 TeV. The data correspond to an integrated luminosity of 19.7 fb(-1). The search considers HH resonances with masses between 1 and 3 TeV, having final states of two b quark pairs. Each Higgs boson is produced with large momentum, and the hadronization products of the pair of b quarks can usually be reconstructed as single large jets. The background from multijet and t (t) over bar events is significantly reduced by applying requirements related to the flavor of the jet, its mass, and its substructure. The signal would be identified as a peak on top of the dijet invariant mass spectrum of the remaining background events. No evidence is observed for such a signal. Upper limits obtained at 95 confidence level for the product of the production cross section and branching fraction sigma(gg -> X) B(X -> HH -> b (b) over barb (b) over bar) range from 10 to 1.5 fb for the mass of X from 1.15 to 2.0 TeV, significantly extending previous searches. For a warped extra dimension theory with amass scale Lambda(R) = 1 TeV, the data exclude radion scalar masses between 1.15 and 1.55 TeV

Measurement of the top quark mass using charged particles in pp collisions at root s=8 TeV

Peer reviewe

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe