COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

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

Raw data: Synthetically-induced Arabidopsis thaliana autotetraploids provide insights in the analysis of meiotic mutants with altered crossover frequency

Raw data• Mutations affecting crossover frequency and distribution lead to the presence of univalents during meiosis, giving rise to aneuploid gametes and sterility. These mutations may have a different effect after chromosome doubling. The combination of altered ploidy and mutations could be potentially useful to gain new insights into the mechanisms and regulation of meiotic recombination, however, studies using autopolyploid meiotic mutants are scarce. • Here, we have analyzed the cytogenetic consequences in colchicine-induced autotetraploids (colchiploids) from different Arabidopsis mutants with an altered crossover frequency. • We have found that there are three types of mutants: i) mutants in which chiasma frequency is doubled after chromosome duplication (zip4, mus81), as in the control; ii) mutants in which polyploidy leads to higher-than expected increase in chiasma frequency (asy1, mer3, hei10, mlh3); and iii) mutants in which the rise in chiasma frequency produced by the presence of two extra chromosomal sets is less than doubled (msh5, fancm). In addition, the proportion of class I/class II crossovers varies after chromosome duplication in the control. • The results obtained reveal the potential of colchiploid meiotic mutants for better understanding of the function of key proteins during plant meiosis. This is especially relevant considering that most crops are polyploids.Depto. de Genética, Fisiología y MicrobiologíaFac. de Ciencias Biológicasinpres

The Cdk1/Cdk2 homolog CDKA;1 controls the recombination landscape in Arabidopsis

Little is known how patterns of cross-over (CO) numbers and distribution during meiosis are established. Here, we reveal that cyclin-dependent kinase A;1 (CDKA;1), the homolog of human Cdk1 and Cdk2, is a major regulator of meiotic recombination in Arabidopsis. Arabidopsis plants with reduced CDKA;1 activity experienced a decrease of class I COs, especially lowering recombination rates in centromere-proximal regions. Interestingly, this reduction of type I CO did not affect CO assurance, a mechanism by which each chromosome receives at least one CO, resulting in all chromosomes exhibiting similar genetic lengths in weak loss-of-function cdka;1 mutants. Conversely, an increase of CDKA;1 activity resulted in elevated recombination frequencies. Thus, modulation of CDKA;1 kinase activity affects the number and placement of COs along the chromosome axis in a dose-dependent manner.</p

Diagnóstico del mercadeo de la cebolla en la República Dominicana

108 páginasEl proyecto busca mejorar los servicios de comercialización a nivel nacional mediante el fortalecimiento de las instituciones que están operando dentro del sub sector de comercialización. Se pretenden la formulación de un plan nacional de comercialización agropecuaria compatible con el Plan Nacional de Desarrollo Económico y Social

Systemic Autoimmune Diseases in Patients Hospitalized with COVID-19 in Spain: A Nation-Wide Registry Study

We aimed to evaluate the clinical outcome of Systemic Autoimmune Diseases (SADs) patients hospitalized with COVID-19 in Spain, before the introduction of SARS-CoV-2 vaccines. A nationwide, retrospective and observational analysis of the patients admitted during 2020, based on the ICD10 codes in the National Registry of Hospital Discharges, was performed. Among 117,694 patients, only 892 (0.8%) presented any type of SAD before COVID-19-related admission: Sjogren&rsquo;s Syndrome constituted 25%, Systemic Vasculitides 21%, Systemic Lupus Erythematosus 19%, Sarcoidosis 17%, Systemic Sclerosis 11%, Mixed and Undifferentiated Connective Tissue Disease 4%, Beh&ccedil;et&rsquo;s Disease 4% and Inflammatory Myopathies 2%. The in-hospital mortality rate was higher in SAD individuals (20% vs. 16%, p &lt; 0.001). After adjustment by baseline conditions, SADs were not associated with a higher mortality risk (OR = 0.93, 95% CI 0.78&ndash;1.11). Mortality in the SADs patients was determined by age (OR = 1.05, 95% CI 1.04&ndash;1.07), heart failure (OR = 1.67, 95% CI 1.10&ndash;2.49), chronic kidney disease (OR = 1.29, 95% CI 1.05&ndash;1.59) and liver disease (OR = 1.97, 95% CI 1.13&ndash;3.44). In conclusion, the higher COVID-19 mortality rate seen in SADs patients hospitalized in Spain in 2020 was related to the higher burden of comorbidities, secondary to direct organ damage and sequelae of their condition. Whilst further studies should evaluate the impact of baseline immunosuppression on COVID-19 outcomes in this population, efforts should be focused on the optimal management of SAD to minimize the impact of the organ damage that has been shown to determine COVID-19 prognosis

Gestión de redes

Aplicaciones inform&aacute;ticas para el apoyo de la gesti&oacute;n cl&iacute;nica y administrativa en la salud p&uacute;blicaCaracterizaci&oacute;n y an&aacute;lisis de lista de espera odontol&oacute;gicaDesarrollo implementaci&oacute;n y puesta en marcha de software de gesti&oacute;n integral de camas hospitalariasDescongesti&oacute;n de hospitales en zonas de cat&aacute;strofe: modelamiento para Concepci&oacute;n y TalcahuanoElaboraci&oacute;n de normas de referencia y contrarreferencia: red de salud del Servicio Metropolitano SurEstrategias de impacto en la patolog&iacute;a biliar para la disminuci&oacute;n del c&aacute;ncer de ves&iacute;culaHospital San Jos&eacute; de Maipo en campa&ntilde;a de invierno. Respuesta de una red de saludM&eacute;todo de gesti&oacute;n pago por procedimiento (3P): altamente eficiente para aumentar la productividadProceso dirigido al logro de un plan estrat&eacute;gico. Departamento de Salud Municipal, Angol, a&ntilde;o 200

Desarrollo de productos y marketing de los centros de producción de la Universidad Cooperativa de Colombia seccional Bucaramanga.

Este trabajo de grado contiene un estudio detallado de los Centros de Producción Pecuarios de la Universidad Cooperativa de Colombia, ubicados en los municipios de Piedecuesta, San Gil y Santa Marta; donde en la actualidad se encuentran produciendo diferentes tipos de explotaciones pecuarias, entre estas y siendo el objeto de este estudio, las producciones porcícolas y piscícolas. Para la realización de este trabajo de grado, se analizó y evaluó las condiciones, estado y capacidad de producción que se manejan en la actualidad de dichos centros; correspondientes a las producciones porcina y piscícola. Se censo la población de productores existentes hasta el momento, se realizo el estudio de mercados correspondiente de acuerdo a los resultados arrojados por el censo. Con dichos resultados se procedió a una auto evaluación de los centros de Producción Pecuaria de Guatiguara, el Ciruelo y Tayronaca, arrojando un resultado no muy favorable para la producción de cerdos, peces y alevinos en dichos Centros de Producción. No obstante se recomienda la reactivación de manera técnica para un mejor servicio y calidad de los productos; ya que se cuenta con mano de obra calificada, como una alternativa para disminuir costos se procede a dietas no convencionales con productos cultivados en los Centros de Producción, también se da una alternativa en la parte de reproducción, brindando los servicios técnicos en dicha área a las granjas cercanas a nuestros Centros de Producción y por ultimo en relación a la parte técnica y veterinaria se ofrece un bienestar animal para un buen producto final. Teniendo en cuenta el estudio de mercados, basado en un censo realizado en las regiones donde se cuentan con estos Centros de Producción, podemos optar por hacer un mercadeo estratégico aprovechando el mercado interno de la Universidad Cooperativa de Colombia; para ofrecer nuestro producto terminado y así; hacer la producción auto sostenible basándose en una economía sólida y favorable para nuestros productos los cuales llevarían el respaldo de centros de producción que buscan el beneficio y bienestar animal para ofrecer un productos de excelente calidad; ya sea en alevinos, pez cebado, lechones y cerdo cebado. No olvidando de antemano, lo importante que es reactivar económicamente nuestros Centros de Producción para así ser auto sostenibles y entrar a competir en el mercado con precios bajos y de excelente calidad.Introducción. -- 1. Problema. -- 1.1 Definición. -- 1.2 Antecedentes del problema. -- 2. Justificación. -- 3. Objetivos. -- 3.1 General. -- 3.2 Específicos. -- 4. Marco teórico. -- 4.1 Alimentación. -- 4.1.1 Alimentación no convencional. -- 4.1.2 Alternativas de alimentación no convencional. -- 4.2 Bienestar animal. -- 4.2.1 El bienestar y la calidad de la canal o la carne. -- 4.2.2 Requisitos para adherirse al convenio de producción limpia. -- 4.3 Reproducción. -- 4.3.1 Servicio. -- 4.3.2 Chequeos visuales. -- 4.3.3 Hembras repetidoras. -- 4.3.4 Chequeo de preñez. -- 4.3.5 Inseminación artificial. -- 4.4 Construcciones. -- 4.4.1 Instalaciones. -- 5. Esquema temático. -- 5.1 Alimentación. -- 5.1.1 Composición de los alimentos. -- 5.1.2 Alternativas de alimentación no convencional. -- 5.2 Bienestar animal. -- 5.2.1 Sanidad preventiva (biológicos). -- 5.2.2 Reproducción limpia. -- 5.3 Reproducción. -- 5.3.1 Centro de monta. -- 5.4 Construcciones. -- 5.4.1 Instalaciones. -- 5.5 Costos de producción. -- 5.5.1 Costo del lechón al destete. -- 5.5.2 Costo del lechón hasta el 15 kg. -- 5.5.3 Costo de engorde hasta el 95 kg. -- 6. Observaciones. -- 7. Recomendaciones. -- 8. Conclusiones. -- Bibliografía. -- Anexos. [email protected]@[email protected]@[email protected]@[email protected]@[email protected]@[email protected]@[email protected]@[email protected]ñ[email protected]@[email protected]@[email protected]@[email protected]@[email protected]ú[email protected]