Índice de dispersión poblacional distrital (IDP) para la estimación de necesidades de recursos humanos en salud del primer nivel de atención

Introduction: The Ministry of Health of Peru (MINSA) is implementing policies and strategies to ensure equitable access to care, timeliness and quality. Sufficient human resources (RHUS) properly distributed in the different levels of care is needed to accomplish this. Thus, it is essential to adequately estimate the gap of RHUS, especially at primary care level. Objectives: To develop, validate and implement a district population dispersion index (IDP) characterizing the district, and to provide dispersion in estimating RHUS gap at primary care level. Design: Observational and analytical study. Location: Directorate General Management Human Resources Development MINSA, Peru. Participants: All districts of Peru were considered for analysis. Interventions: An exploratory factor analysis was performed. It considered demographic, social and economic access to health services, obtained from the Population and Housing Censuses (2005 and 2007) and the National Continuing Survey (2006) variables. The IDP was structured and validated against the official list of villages and the perception of health officers of regional governments. Main outcome measures: IDP. Results: Out of 1 831 municipalities evaluated, we classified 1 277 districts as rural, according to the classification of the Presidency of the Council of Ministers (PCM). They were considered as scattered by the methodology. Concordance was 82%. Conclusions: The IDP is a useful indicator to estimate the gaps of RHUS for health services at primary care level in Peru.Introducción: El Ministerio de Salud de Perú (MINSA) viene implementando políticas y estrategias orientadas a garantizar el acceso a atención con equidad, oportunidad y calidad; para lo cual se requiere contar con recursos humanos (RHUS) suficientes y adecuadamente distribuidos en los diferentes niveles de atención. Así, es fundamental estimar la brecha de RHUS especialmente en el primer nivel de atención, incorporando en particular como criterio, la dispersión poblacional presente en el país. Objetivos: Diseñar, validar y aplicar un índice de dispersión poblacional distrital (IDP) que caracterice la dispersión distrital y aporte en la estimación de brecha de RHUS en el primer nivel de atención. Diseño: Estudio observacional y analítico, análisis multivariado. Lugar: Dirección General de Gestión del Desarrollo de Recursos Humanos MINSA, Perú. Participantes: Se consideró como unidad de análisis la totalidad de los distritos del Perú. Intervenciones: Análisis factorial exploratorio que considera variables demográficas, sociales, económicas y de acceso a los servicios de salud, obtenidas de los Censos de Población y Vivienda (2005 y 2007) y la Encuesta Nacional Continua (2006). Principales medidas de resultado: Índice de dispersión poblacional distrital. Resultados: El IDP fue estructurado y validado con la relación oficial de municipios rurales y la percepción de los operadores sanitarios de los Gobiernos Regionales del país. De las 1 831 municipalidades evaluadas, se clasificó los 1 277 distritos considerados rurales de acuerdo a la clasificación de Presidencia de Consejo de Ministros (PCM) como dispersos por la metodología; se identificó un 82% de concordancia. Conclusiones: El IDP diseñado y validado aporta en la estimación de brechas de RHUS para los servicios asistenciales del primer nivel de atención en el Perú

Antifungal properties and biocompatibility of silver nanoparticle coatings on silicone maxillofacial prostheses in vitro

Patients with facial prostheses suffer from yeast, Candida albicans, infections. This study aimed to determine the biocompatibility and antifungal properties of silicone facial prostheses coated with silver nanoparticles (Ag NPs) in vitro. Medical grade silicone discs were coated with 5 and 50 mg L−1 dispersions of either Ag NPs or AgNO3. Coatings were fully characterized using scanning electron microscopy and energy dispersive X‐ray spectroscopy. The biocompatibility was examined using human dermal fibroblasts (Hs68), whereas antifungal efficacy was tested against C. albicans (NCPF‐3179). The fibroblast viability was assessed by measuring lactate dehydrogenase (LDH) activity, protein content and tissue electrolytes. There were no effects on the LDH activity of fibroblast cell homogenates, and leak of LDH activity into external media remained low (0.1–0.2 IU mL−1). Sublethal effects of Ag NP coatings on membrane permeability/ion balance was not observed, as measured by stable homogenate Na+ and K+ concentrations. Some Ag (13 mg L−1) was detected from the AgNO3 coatings in the media, but total Ag remained below detection limit (<1.2 µg L−1) for the Ag NP coatings; indicating the latter were stable. When fibroblasts grown on silver coatings were challenged with C. albicans, the Ag NP coating was effective at preventing fungal growth as measured by ethanol production by the yeast, and without damaging the fibroblasts. Ethanol production decreased from 43.2 ± 25.02 in controls to 3.6 µmol mL−1 in all the silver treatments. Data shows that silicone prosthetic materials coated with Ag NPs are biocompatible with fibroblast cells in vitro and show antifungal properties. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1038–1051, 2018.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142985/1/jbmb33917_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142985/2/jbmb33917.pd

Diagnóstico biomolecular de anomalías genéticas asociadas a Fibrosis Quística usando indicadores mutagénicos.

Pacientes diagnosticados con Fibrosis Quística provenientes del Instituto de Salud del Niño del Ministerio de Salud del Perú y del Hospital IV E. Rebagliatti Martins (Seguridad Social), fueron evaluados durante el segundó semestre del 2013 con la finalidad de detectar mutaciones del Gen C.F.T.R. (Regulador de la Conductancia Transmembrana de la Fibrosis Quística). Mediante el método de la A.R.M.S-P.C.R (Reacción en Cadena de la Polimerasa- Sistema de amplificación de la Mutación Refractaria), se analizaron 28 muestras, encontrándose que en el 21,42% estaban presente dos mutaciones y el 32,21% una mutación. La prevalencia de DF508 en Perú, es relativamente baja (31,30%) en comparación con el promedio latinoamericano (43,54%). Al contrario los pacientes peruanos presentan una tasa importante de G542X (7,40%) en comparación con los de Latinoamérica (5,10%)

Sequential decoupling of negative-energy states in Douglas-Kroll-Hess theory

Here, we review the historical development, current status, and prospects of Douglas--Kroll--Hess theory as a quantum chemical relativistic electrons-only theory.Comment: 15 page

Global and decomposition evolutionary support vector machine approaches for time series forecasting

Multi-step ahead Time Series Forecasting (TSF) is a key tool for support- ing tactical decisions (e.g., planning resources). Recently, the support vector machine emerged as a natural solution for TSF due to its nonlinear learning capabilities. This paper presents two novel Evolutionary Support Vector Machine (ESVM) methods for multi-step TSF. Both methods are based on an Estimation Distribution Algorithm (EDA) search engine that automatically performs a simultaneous variable (number of inputs) and model (hyperparameters) selection. The Global ESVM (GESVM) uses all past patterns to fit the support vector machine, while the Decomposition ESVM (DESVM) separates the series into trended and stationary effects, using a distinct ESVM to forecast each effect and then summing both predictions into a sin- gle response. Several experiments were held, using six time series. The proposed approaches were analyzed under two criteria and compared against a recent Evolu- tionary Artificial Neural Network (EANN) and two classical forecasting methods, Holt-Winters and ARIMA. Overall, the DESVM and GESVM obtained competitive and high quality results. Furthermore, both ESVM approaches consume much less computational effort when compared with EANN.The authors wish to thank Ramon Sagarna for introducing the subject of EDA. The work of P. Cortez was supported by FEDER (program COMPETE and FCT) under project FCOMP-01-0124-FEDER-022674

Self-diffusion of adatoms, dimers, and vacancies on Cu(100)

We use ab initio static relaxation methods and semi-empirical molecular-dynamics simulations to investigate the energetics and dynamics of the diffusion of adatoms, dimers, and vacancies on Cu(100). It is found that the dynamical energy barriers for diffusion are well approximated by the static, 0 K barriers and that prefactors do not depend sensitively on the species undergoing diffusion. The ab initio barriers are observed to be significantly lower when calculated within the generalized-gradient approximation (GGA) rather than in the local-density approximation (LDA). Our calculations predict that surface diffusion should proceed primarily via the diffusion of vacancies. Adatoms are found to migrate most easily via a jump mechanism. This is the case, also, of dimers, even though the corresponding barrier is slightly larger than it is for adatoms. We observe, further, that dimers diffuse more readily than they can dissociate. Our results are discussed in the context of recent submonolayer growth experiments of Cu(100).Comment: Submitted to the Physical Review B; 15 pages including postscript figures; see also http://www.centrcn.umontreal.ca/~lewi

The Autism Spectrum Disorder-Associated Bacterial Metabolite p-Cresol Derails the Neuroimmune Response of Microglial Cells Partially via Reduction of ADAM17 and ADAM10.

The bacterial metabolite 4-methylphenol ( para-cresol or p-cresol) and its derivative p-cresyl sulfate ( pCS) are elevated in the urine and feces of children with autism spectrum disorder (ASD). It has been shown that p-cresol administration induces social behavior deficits and repetitive behavior in mice. However, the mechanisms of p-cresol, specifically its metabolite pCS that can reach the brain, in ASD remain to be investigated. The pCS has been shown to inhibit LPS-stimulated inflammatory response. A Disintegrin And Metalloprotease 10 (ADAM10) and A Disintegrin And Metalloprotease 17 (ADAM17) are thought to regulate microglial immune response by cleaving membrane-bound proteins. In the present study, a neuroinflammation model of LPS-activated BV2 microglia has been used to unveil the potential molecular mechanism of pCS in ASD pathogenesis. In microglial cells pCS treatment decreases the expression or maturation of ADAM10 and ADAM17. In addition, pCS treatment attenuates TNF-α and IL-6 releases as well as phagocytosis activity of microglia. In in vitro ADAM10/17 inhibition experiments, either ADAM10 or ADAM17 inhibition reduces constitutive and LPS-activated release of TNF-α, TNFR-1 and IL-6R by microglial cells, while it increases constitutive and LPS-activated microglial phagocytotic activity. The in vivo results further confirm the involvement of ADAM10 and ADAM17 in ASD pathogenesis. In in utero VPA-exposed male mice, elevated concentration in serum of p-cresol-associated metabolites pCS and p-cresyl glucuronide ( pCG) is associated with a VPA-induced increased ADAM10 maturation, and a decreased ADAM17 maturation that is related with attenuated levels of soluble TNF-α and TGF-β1 in the mice brain. Overall, the present study demonstrates a partial role of ADAM10 and ADAM17 in the derailed innate immune response of microglial cells associated with pCS-induced ASD pathogenesis

Open and Hidden Charm Production in 920 GeV Proton-Nucleus Collisions

The HERA-B collaboration has studied the production of charmonium and open charm states in collisions of 920 GeV protons with wire targets of different materials. The acceptance of the HERA-B spectrometer covers negative values of xF up to xF=-0.3 and a broad range in transverse momentum from 0.0 to 4.8 GeV/c. The studies presented in this paper include J/psi differential distributions and the suppression of J/psi production in nuclear media. Furthermore, production cross sections and cross section ratios for open charm mesons are discussed.Comment: 5 pages, 9 figures, to be published in the proceedings of the 6th International Conference on Hyperons, Charm & Beauty Hadrons (BEACH04), Chicago, IL, June 27 - July 3, 200

Search for the Flavor-Changing Neutral Current Decay D0→μ+μ−D^0 \to \mu^+\mu^- with the HERA-B Detector

We report on a search for the flavor-changing neutral current decay $D^0 \to \mu^+\mu^-$ using $50 \times 10^6$ events recorded with a dimuon trigger in interactions of 920 GeV protons with nuclei by the HERA-B experiment. We find no evidence for such decays and set a 90% confidence level upper limit on the branching fraction $Br(D^0 \to \mu^+\mu^-) <2.0 \times 10^{-6}$.Comment: 17 pages, 4 figures (of which 1 double), paper to be submitted to Physics Letters