Boletín Económico Regional : Centro, I trimestre de 2014

Los resultados logrados por la economía de la región Centro durante el primer trimestre de 2014 no fueron homogéneos. De esta manera, se registró un comportamiento bastante positivo en las captaciones y colocaciones del sistema financiero, al igual que en el mercado inmobiliario donde se revirtió la tendencia decreciente, así como en el mercado laboral al reducirse la tasa de desempleo. Los resultados fueron favorables, aunque en menor magnitud que los anteriores, en el otorgamiento de créditos por parte de Finagro, en el área aprobada para construcción, en la actividad comercial, incluida la venta de vehículos nuevos, y en la producción de sal. Entre tanto, la variación del nivel de precios fue disímil, mientras que arrojaron un balance desfavorable los principales cultivos transitorios por el desajuste climático, las exportaciones e importaciones, así como la extracción de petróleo

Memorias de investigación: Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.

Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.Esta publicación busca divulgar investigaciones y producción académica en diferentes disciplinas, realizadas por estudiantes y docentes de UNIMINUTO Seccional Antioquia – Chocó, así como dar a conocer los semilleros de investigación que participaron en la V Feria de Semilleros, con el fin de visibilizar el trabajo que realiza el Centro de Investigación para el Desarrollo de UNIMINUTO Bello —CIDUB—, con respecto a debates académicos y espacios de interlocución. Igualmente, permite que la comunidad educativa conozca los temas de investigación y las discusiones que se están dando entre los semilleros y grupos de investigación, para así buscar puntos de encuentro y sinergias entre los investigadores. Adicionalmente, el texto se convierte en una invitación para que se vinculen otros investigadores, docentes, estudiantes e incluso otras instituciones a los procesos investigativos coordinados desde el CIDUB

Memorias de investigación: Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.

Feria de Semilleros y Jornadas de Investigación de uniminuto, Seccional Antioquia - Chocó.Esta publicación busca divulgar investigaciones y producción académica en diferentes disciplinas, realizadas por estudiantes y docentes de UNIMINUTO Seccional Antioquia – Chocó, así como dar a conocer los semilleros de investigación que participaron en la V Feria de Semilleros, con el fin de visibilizar el trabajo que realiza el Centro de Investigación para el Desarrollo de UNIMINUTO Bello —CIDUB—, con respecto a debates académicos y espacios de interlocución. Igualmente, permite que la comunidad educativa conozca los temas de investigación y las discusiones que se están dando entre los semilleros y grupos de investigación, para así buscar puntos de encuentro y sinergias entre los investigadores. Adicionalmente, el texto se convierte en una invitación para que se vinculen otros investigadores, docentes, estudiantes e incluso otras instituciones a los procesos investigativos coordinados desde el CIDUB

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p < 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

El poder creador del juez en la combinación o mezcla de los procedimientos constitucionales

El presente artículo es una reseña explicativa de la creatividad del juez para combinar elementos de los procesos constitucionales con el fin de fortalecer los derechos fundamentales. Se presentará a continuación un análisis de las fuentes de derecho y su valor equivalente en los razonamientos constitucionales. Subrayando la equidad en la importancia de las fuentes, el presente artículo busca incentivar la labor conciliadora de los jueces y los procesos de creación del derecho bajo los límites de la coherencia jurídica. Se explicarán a continuación los eventos en los cuáles puede cambiarse la jurisprudencia y sus ventajas para garantizar la evolución del derecho constitucional. Uno de los cambios más importantes de la jurisprudencia, es la tendencia que muestra la articulación de los procedimientos constitucionales

The creative powder of the judge within the mix of constitucional procedures

El presente artículo es una reseña explicativa de la creatividad del juez para combinar elementos de los procesos constitucionales con el fin de fortalecer los derechos fundamentales. Se presentará a continuación un análisis de las fuentes de derecho y su valor equivalente en los razonamientos constitucionales. Subrayando la equidad en la importancia de las fuentes, el presente artículo busca incentivar la labor conciliadora de los jueces y los procesos de creación del derecho bajo los límites de la coherencia jurídica. Se explicarán a continuación los eventos en los cuáles puede cambiarse la jurisprudencia y sus ventajas para garantizar la evolución del derecho constitucional. Uno de los cambios más importantes de la jurisprudencia, es la tendencia que muestra la articulación de los procedimientos constitucionales.This article provides an explanatory summary of the judicial creativity so as to combine elements of constitutional processes to strengthen fundamental rights. It then presents an analysis of the sources of law and their equivalents in constitutional reasoning. To underline equity in the importance of sources, this article seeks to encourage the conciliatory work of the judges and creation of law within the limits of a coherent jurisprudence. The article then examines those areas in which the jurisprudence may change and the advantages of this for the evolution of constitutional law. One of the most important jurisprudential changes is the trend towards articulating the constitutional procedures

El Razonamiento Jurídico del Juez y las Formas Mixtas de Justicia Constitucional desde una Perspectiva Comparativa

The following work attempts to define the scope of judicial activism in a state subject to the rule of law (State of Law). In sum, it defends a moderate legal positivism system: judges' creativity must be subject to the Constitution and the legal system.Las siguientes reflexiones tienen por objeto definir un activismo judicial en un Estado de Derecho.En suma, se presenta un positivismo jurídico moderado; la definición de la creatividad del juez sometida a la Constitución y al ordenamiento jurídico pre-establecido