Dietary fatty acids and lipoproteins on progression of age-related macular degeneration

Age-related macular degeneration (AMD) is a medical condition of central loss vision and blindness. Numerous studies have revealed that changes on certain dietary fatty acids (FAs) could have useful for AMD management. This review summarizes the effects of dietary omega-3 long-chain PUFAs, MUFAs, and SFAs, and lipoproteins on AMD. Findings are consistent with the beneficial role of dietary omega-3 long-chain PUFAs, while the effects of dietary MUFAs and SFAs appeared to be ambiguous with respect to the possible protection from MUFAs and to the possible adverse impact from SFAs on AMD. Some of the pathological mechanisms associated with lipoproteins on AMD share those observed previously in cardiovascular diseases. It was also noticed that the effects of FAs in the diet and lipoprotein on AMD could be modulated by genetic variants. From a population health perspective, the findings of this review are in favour of omega-3 long-chain FAs recommendations in a preventive and therapeutic regimen to attain lower AMD occurrence and progression rates. Additional long-term and short-term nutrigenomic studies are required to clearly establish the role and the relevance of interaction of dietary FAs, lipoproteins, and genes in the genesis and progression of AMD

Gestión de la comunicación aplicada

La gestión de proyectos aplicados se refiere al enfoque práctico y sistemático utilizado para planificar, organizar y controlar el trabajo necesario para completar un proyecto de manera eficiente y efectiva. Esto implica identificar los objetivos, definir las tareas y actividades necesarias para completar la propuesta, asignar recursos y establecer un cronograma para el trabajo. Además, monitorear y controlar el progreso del proyecto para asegurarse de que se está avanzando de acuerdo con el plan y tomar medidas para solucionar posibles problemas o desafíos que puedan surgir

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Ecos de la academia: Revista de la Facultad de Educación, Ciencia y Tecnología - FECYT Nro 4

Ecos de la academia, Revista de la Facultad de Educación Ciencia y Tecnología es una publicación científica de la Universidad Técnica del Norte, con revisión por pares a doble ciego que publica artículos en idioma español, quichua, portugués e inglés. Se edita con una frecuencia semestral con dos números por año.En ella se divulgan trabajos originales e inéditos generados por los investigadores, docentes y estudiantes de la FECYT, y contribuciones de profesionales de instituciones docentes e investigativas dentro y fuera del país, con calidad, originalidad y relevancia en las áreas de ciencias sociales y tecnología aplicada.Los orígenes de la fotografía en la segunda ciudad de Cataluña: Reus, 1839-1903. Hábitos de consumo y uso de medios digitales en los estudiantes de la Universidad Técnica del Norte. Gastronomía, historia y cultura afrodescendiente de las comunidades Chota y Salinas en Imbabura, Ecuador. Los organizadores gráficos: elementos y procedimientos básicos para su diseño. Análisis del desempeño profesional del graduado de la carrera de Licenciatura en Inglés de la Universidad Técnica del Norte. Uso del software Aleks como complemento en la asignatura de Fundamentos de Matemáticas del curso de nivelación EPN-SENECYT. La educación de postgrado y la enseñanza de Redes Neuronales Artificiales como herramienta versátil para egresados. Home is an uneasty place: Afroperipheralism anda diasporic sensibilities in Wayde Compton’s “The Instrumental”. Respuesta de la carrera de Educación Básica a las necesidades sociales en la Zona 1 del Ecuador. Programa SaludArte: Salud, Alimentación y Movimiento entran a las escuelas para mejorar la calidad educativa. Tendencias de consumo turístico de los Millennials en la ciudad de Ibarra. Los Grupos de Investigación como estrategias para desarrollo de la investigación científica en las instituciones de educación superior ecuatorianas. Paradigmas y modelos pedagógicos de los postulados científicos en el espacio de aula en la Universidad Técnica de Ambato. Predicting academic performance in traditional environments at higher-education institutions using data mining: A review. El Proyecto de Investigación “Muros que hablan. Un recorrido por los graffitis de Imbabura”. Construcción de la marca ciudad. Normas de presentación de artículos científicos en la revista Ecos de la Academia

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

Viaje al centro de la ciencia

Se desarrolla un proyecto de innovación educativa que pretende aglutinar a todos los niveles y áreas en que se implique toda la comunidad educativa. Se trata de fomentar el interés por la ciencia a través de la lectura de libros de divulgación científica y de ciencia ficción, realizando actividades que contemplen el protagonismo de los alumnos en la divulgación de experiencias de física, favoreciendo la enseñanza del conocimiento científico desde distintas áreas como Historia, Geografía, e idiomas, y facilitando el uso de las TIC. El proyecto se ha desarrollado en cinco fases: en la primera se diseña y programa el proyecto, en la segunda se pone en marcha el proyecto realizando reuniones grupales; en la tercera se realiza el seguimiento del proyecto de innovación; en la cuarta se evalúa el proceso; y en la quinta se considera la posibilidad de dar continuidad en cursos sucesivos a actividades como las jornadas de Ciencia. Tras la realización del proyecto se favorece el aprendizaje de los alumnos y alumnas a través del trabajo en equipo y la coordinación por niveles y materias. Se ha desarrollado diversos materiales, se han realizado jornadas de puertas abiertas y exposiciones sobre los materiales y aparatos e instrumentos creados. El proyecto ha propiciado un ambiente de trabajo, colaboración y de convivencia, ampliando los conocimientos sobre múltiples aspectos de la Ciencia.Castilla y LeónConsejería de Educación. Dirección General de Universidades e Investigación; Monasterio de Nuestra Señora de Prado, Autovía Puente Colgante s. n.; 47071 Valladolid; +34983411881; +34983411939ES

Cine mexicano y realidad social. Distintas miradas

A partir de “distintas miradas” y perspectivas analíticas disciplinarias, este libro integra aspectos relevantes de la cinematografía nacional a través de una serie de películas seleccionadas por sus autores; espacio en el que confluyen: literatura, arqueología, sociología, antropología, artes escénicas, historia, geografía y comunicación. Reflexionar acerca de la relación entre el cine mexicano y la realidad social del país a partir de ciertas películas producidas en distintos momentos del siglo XX y del XXI, es el motivo de este libro, mismo que postula al cine como reflejo de nuestra historia cultural, y fuente de su conocimiento y representatividad. Correlación indisociable que ha existido desde sus inicios, como lo ha planteado claramente el historiador Aurelio de los Reyes, ya sea rescatando la idiosincrasia de una sociedad, las maneras de hablar o vestir, la arquitectura de la época, los tabúes o temas representativos del tiempo. Voz que se suma a la del historiador inglés Marc Ferro quien ha reconocido en el cine la fuerza de la imagen como un documento histórico y agente testimonial de gran valía, que puede llegar incluso a funcionar como una herramienta útil para el análisis de la realidad social. Además, Pierre Sorlin reconoce en el cine un agente de la historia que puede tener efectos de representación del pasado, e integrarse al mismo tiempo como testimonio vivo. Principales coordenadas en las que se ubica el presente libro