Infectious Diseases, Social, Economic and Political Crises, Anthropogenic Disasters and Beyond: Venezuela 2019 – Implications for Public Health and Travel Medicine

During last months, there have been a significant increase in the evidences showing the catastrophic health situation in Venezuela. There are multiple epidemics, increase in emerging and reemerging infectious, tropical and parasitic diseases as consequences of the social, economic and political crises, which would be considered today a clearly anthropogenic disaster. Venezuela is facing in 2019, the worse sanitary conditions, with multiple implications for public health and travel medicine. So far, from a global perspective, this situation will be an impediment for the achievement of the sustainable development goals (SDG) in 2030. In this multiauthor review, there is a comprehensive analysis of the situation for infectious diseases, non-communicable diseases, their impact in the Americas region, given the migration crisis as well as the comparative status of the SDG 2030. This discussion can provide input for prioritizing emerging health problems and establish a future agenda

Infectious Diseases, Social, Economic and Political Crises, Anthropogenic Disasters and Beyond: Venezuela 2019 – Implications for Public Health and Travel Medicine

During last months, there have been a significant increase in the evidences showing the catastrophic health situation in Venezuela. There are multiple epidemics, increase in emerging and reemerging infectious, tropical and parasitic diseases as consequences of the social, economic and political crises, which would be considered today a clearly anthropogenic disaster. Venezuela is facing in 2019, the worse sanitary conditions, with multiple implications for public health and travel medicine. So far, from a global perspective, this situation will be an impediment for the achievement of the sustainable development goals (SDG) in 2030. In this multiauthor review, there is a comprehensive analysis of the situation for infectious diseases, non-communicable diseases, their impact in the Americas region, given the migration crisis as well as the comparative status of the SDG 2030. This discussion can provide input for prioritizing emerging health problems and establish a future agenda

Build your own closed loop: Graph-based proof of concept in closed loop for autonomous networks

Next Generation Networks (NGNs) are expected to handle heterogeneous technologies, services, verticals and devices of increasing complexity. It is essential to fathom an innovative approach to automatically and efficiently manage NGNs to deliver an adequate end-to-end Quality of Experience (QoE) while reducing operational expenses. An Autonomous Network (AN) using a closed loop can self-monitor, self-evaluate and self-heal, making it a potential solution for managing the NGN dynamically. This study describes the major results of building a closed-loop Proof of Concept (PoC) for various AN use cases organized by the International Telecommunication Union Focus Group on Autonomous Networks (ITU FG-AN). The scope of this PoC includes the representation of closed-loop use cases in a graph format, the development of evolution/exploration mechanisms to create new closed loops based on the graph representations, and the implementation of a reference orchestrator to demonstrate the parsing and validation of the closed loops. The main conclusions and future directions are summarized here, including observations and limitations of the PoC

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Diseño de una red logística integral para optimizar los tiempos de entrega de producto terminado para el Sector Cementero

Hoy en día las exigencias del mercado nacional e internacional del sector cementero se enfrentan a grandes retos día a día pues al estar inmersas en un mercado deben de buscar habilidades y estrategias que les permitan estar a la vanguardia. México es uno de los productores más importantes de cemento en el mundo gracias al desempeño productivo en el sector de la construcción el cual es uno de los pilares significativos para la economía del país, lo cual permite posicionar al sector cementero como uno de los más importantes a nivel nacional, por lo cual es importante que este sector cuente con una red logística integral que permita un flujo de información adecuado y que involucre a toda la cadena de suministro. En el presente trabajo se dan a conocer datos obtenidos de acuerdo al tipo de investigación empleada generando nuevas metodologías en el desarrollo y análisis descriptivo de los tiempos de entrega en el sector cementero, se presentan las diferentes técnicas y estrategias que se desarrollaron y que coadyuvaron en la realización de la red logística, además se describen y desarrollan ampliamente los objetivos específicos que darán lugar a justificar el panorama actual que se presenta en la entrega de producto terminado, así mismo se presenta la solución que se propone para hacer más eficiente los tiempos de entrega y que dará lugar a constituir una empresa más competitiva en el sector cementero

Infectious Diseases, Social, Economic and Political Crises, Anthropogenic Disasters and Beyond: Venezuela 2019 – Implications for Public Health and Travel Medicine

During last months, there have been a significant increase in the evidences showing the catastrophic health situation in Venezuela. There are multiple epidemics, increase in emerging and reemerging infectious, tropical and parasitic diseases as consequences of the social, economic and political crises, which would be considered today a clearly anthropogenic disaster. Venezuela is facing in 2019, the worse sanitary conditions, with multiple implications for public health and travel medicine. So far, from a global perspective, this situation will be an impediment for the achievement of the sustainable development goals (SDG) in 2030. In this multiauthor review, there is a comprehensive analysis of the situation for infectious diseases, non-communicable diseases, their impact in the Americas region, given the migration crisis as well as the comparative status of the SDG 2030. This discussion can provide input for prioritizing emerging health problems and establish a future agenda

La pizarra digital como ayuda y apoyo a la pizarra tradicional

La Pizarra Digital Interactiva supone un recurso tecnológico consistente en un ordenador multimedia conectado a la intranet del centro y a internet y a un proyector que se refleja en una pantalla interactiva de gran tamaño. Es un recurso didáctico que mejora la interactividad y la motivación de los alumnos. Se marcan como objetivos usar la Pizarra Digital en el proceso cotidiano de enseñanza-aprendizaje; establecer un catálogo de utilidades de la pizarra diferenciado por niveles y áreas de conocimiento; presentar la información en recursos multimedia y elaborar documentos adaptados a las necesidades del centro. Además, con esta herramienta se facilita el intercambio de información y experiencias; y se logra un mayor y mejor acceso de los alumnos a los recursos que ofrecen las nuevas tecnologías. En cuanto a las actividades, se organizan cursos, seminarios y ponencias sobre tecnología educativa; se realiza una revisión del proyecto educativo del centro y de los proyectos curriculares de cada etapa; se realiza un inventario de los recursos referidos a las tecnologías de la información y a la comunicación de los que se dispone en el centro; se realizan reuniones periódicas para compartir experiencias de los docentes; se crean nuevo recursos multimedia adaptados; y se recopila nuevo material didáctico. Incluye DVD con los materiales elaborados.Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES