Ciudad-territorio sustentable. Procesos, actores y estructuras

En los últimos años, los estudios urbanos especializados insisten en que los procesos de urbanización por los que atraviesan los distintos países desarrollados, parecen dejar atrás las explicaciones de la urbanización industrial, han surgido otras construcciones y perspectivas unas más acabadas que otras (Indovina, 1998, la “ciudad difusa”; Dematteis 1998, ciudad sin centros; Nel-lo, 1998 ciudad sin confines, Soja, 2008, la exópolis). En suma se dice que se avanza hacia la urbanización generalizada, ello acaba con la larga trayectoria del funcionamiento y naturaleza de la ciudad moderna, el cambio urbano estructural actual, es nuevamente, consecuencia de la descentralización, difusión, redistribución del desarrollo, del crecimiento y las innovaciones ahora sobre una estructura en el territorio. Ha sido una mutación no sólo empírica sino que ha dado lugar a la confrontación teórica. El sistema urbano jerárquico ha reducido su valor interpretativo porque se han modificado los supuestos en los que se basaban las relaciones de dominio y dependencia de los centros principales, porque se han abaratado los costos de transporte y el efecto de la distancia ya no es una limitante absoluta, ahora los procesos productivos flexibles y descentralizados propician las relaciones técnicas horizontales con lo cual se consiguen economías de escala externas e internas a las empresas en un territorio ampliado y no sólo exclusivamente en la aglomeración económica (Precedo, 2003; Veltz, 1999; Boix, 2002; Camagni, 2005; De Santiago, 2008 y; Garmendia, 2010).El objetivo es examinar dentro de la descentralización del proceso urbano a la ciudad-territorio en América Latina, en particular en México. En contextos urbanos desarrollados se afirma la convergencia urbana con la apertura de las unidades funcionales de los sistemas urbanos donde operan redes e interrelaciones de desarrollo cualitativo en el territorio. América Latina registra evidencias empíricas poco claras, existe alta concentración de aquella economía que contribuye al crecimiento nacional, mientras la población se descentraliza rápidamente. México, es un caso de primacía urbana histórica aunque da paso a la formación de regiones urbanas, mismas que reproducen relaciones polarizadas y escasamente descentralizadas. De manera que, en tanto domine la concentración espacial económica, la ciudadterritorio se podrá presentar en el continente sólo con algunos rasgos en regiones urbanas con mayor desarrollo y crecimiento. Palabras claves: descentralización urbana, sistema urbano, ciudad-territorio

COVID-19 vaccine failure

COVID-19 affects the population unequally with a higher impact on aged and immunosuppressed people. Hence, we assessed the effect of SARS-CoV-2 vaccination in immune compromised patients (older adults and oncohematologic patients), compared with healthy counterparts. While the acquired humoral and cellular memory did not predict subsequent infection 18 months after full immunization, spectral and computational cytometry revealed several subsets within the CD8+ T-cells, B-cells, NK cells, monocytes and CD45RA+ CCR7- Tγδ cells differentially expressed in further infected and non-infected individuals not just following immunization, but also prior to that. Of note, up to 7 subsets were found within the CD45RA+ CCR7- Tγδ population with some of them being expanded and other decreased in subsequently infected individuals. Moreover, some of these subsets also predicted COVID-induced hospitalization in oncohematologic patients. Therefore, we hereby have identified several cellular subsets that, even before vaccination, strongly related to COVID-19 vulnerability as opposed to the acquisition of cellular and/or humoral memory following vaccination with SARS-CoV2 mRNA vaccines.This study has been funded through Programa Estratégico Instituto de Biología y Genética Molecular (IBGM Junta de Castilla y León. Ref. CCVC8485), Junta de Castilla y León (Proyectos COVID 07.04.467B04.74011.0) and the European Commission – NextGenerationEU (Regulation EU 2020/2094), through CSIC's Global Health Platform (PTI Salud Global; SGL21-03-026 and SGL2021-03-038)N

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

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 middle-income 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 low-income 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 low-income, 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

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

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

Finanzas Corporativas II - EF80 - 202102

Descripción: El curso es obligatorio para las carreras de la Facultad de Economía, y perteneciente a la línea de Finanzas. Se enfoca en proporcionar a los estudiantes elementos teóricos y prácticos básicos en torno a cuatro (5) temas principales: Teoría general del portafolio, Valorización de Acciones, Gestión del riesgo y rendimiento de portafolios, Estructura y Presupuesto de capital y Política de dividendos. Propósito: Este curso propone desarrollar las habilidades de construcción de portafolio óptimo de títulos de renta variable, mediante la evaluación y selección individual de inversiones, así como en el contexto de portafolio. Asimismo la evaluación de proyectos considerando su estructura y presupuesto de capital haciendo uso de herramientas que permitan potenciar el razonamiento económico y financiero. Es un curso enfocado en el desarrollo de la competencia general de Pensamiento innovador, y las competencias específicas de Análisis Económico Aplicado, y de Análisis Financiero; todas ellas en el Nivel 2

Recuperación de compuestos fenólicos de residuos Recuperación de compuestos fenólicos de residuos olivícolas: selección de variables relevantes y optimización del proceso: selección de variables relevantes y optimización del proceso

Argentina es el principal productor y exportador de aceite de oliva de América del Sur, y el décimo a nivel mundial. Entre las provincias productoras se destacan, San Juan, Catamarca, La Rioja, Mendoza y Córdoba. Si bien existen distintas metodologías en la extracción de aceite, en Argentina se realiza principalmente por métodos continuos de dos fases, obteniendo por un lado, una fase oleosa de donde se extrae el aceite, y por el otro un residuo semisólido constituido por restos de piel, carozo, pulpa y agua de vegetación de aceitunas, al que comúnmente se denomina alperujo. En San Juan, se generan anualmente entre 60.000 t y 80.000 t de alperujo. Este subproducto es mayoritariamente aplicado al suelo de forma no reglamentada. En los últimos años se han realizado investigaciones locales relacionadas a esta práctica que han permitido la redacción de una normativa de aplicación controlada de residuos olivícolas al suelo. Esta práctica representa una alternativa sencilla para disponer los residuos generados por las industrias, pero posee ciertas restricciones de uso y además dista de ser una opción que permita aprovechar integralmente todos los constituyentes del alperujo. El aceite de oliva virgen es conocido por sus excelentes cualidades nutracéuticas, muchas de las cuales se deben a la presencia de compuestos fenólicos bioactivos conformados por un inmenso grupo de compuestos derivados en su mayoría de la oleoeuropeína, dentro de los cuales el hidroxitirosol (3,4-dihidroxifeniletanol, HT) es el más abundante y estudiado, destacándose principalmente por su gran actividad como antioxidante natural. De estos compuestos, solo el 2 % pasan al aceite, quedando el 98% en el alperujo y normalmente desechados junto a él. Considerando que el mercado de antioxidantes naturales es una actividad en expansión a nivel mundial, se entiende que la recuperación de los compuestos fenólicos a partir del alperujo podría representar una opción económicamente viable en pos de valorizar este residuo. En la bibliografía se describen distintas metodologías de recuperación de compuestos fenólicos de alperujo, pero pocas de ellas son aplicables a escala industrial . La reciente implantación en las orujeras españolas de tratamientos térmicos marca un nuevo escenario para la recuperación de componentes de alto valor agregado, unido a la aplicación de bioprocesos para su uso integral. Actualmente se implementan dos tipos de tratamientos térmicos a nivel industrial, por un lado tratamientos al vapor, y por el otro termobatidos. Ambos sistemas facilitan la separación de fases a través del calentamiento del alperujo y permiten la recuperación de distintos componentes (líquido con alta concentración de compuestos fenólicos bioactivos; aceite y sólido desfenolizados con baja humedad). En este sentido, el objetivo del presente trabajo fue determinar condiciones experimentales, aplicables a escala industrial, tendientes a mejorar la aptitud del alperujo para la recuperación de compuestos fenólicos, posibilitando el aprovechamiento posterior de las distintas fracciones que se obtengan. Específicamente, se evaluó el efecto de tratamientos térmicos y posterior centrifugación del alperujo sobre el volumen de líquido recuperado y la correspondiente concentración de compuestos fenólicos.EEA San JuanFil: Rodriguez, Manuel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria San Juan; ArgentinaFil: Gil, R. Universidad Nacional de San Juan. Facultad de Ingeniería; ArgentinaFil: Rodriguez, L. Universidad Nacional de San Juan. Facultad de Ingeniería; ArgentinaFil: Vallejo, M. Universidad Nacional de San Juan. Facultad de Ingeniería; ArgentinaFil: Cornejo, Vanina. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria San Juan; ArgentinaFil: Gines, Lorena. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria San Juan; ArgentinaFil: Rodriguez Gutierrez, G. Universidad Nacional de San Juan. Facultad de Ingeniería; ArgentinaFil: Monetta, Pablo Miguel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria San Juan; Argentin

Tecnología de los Procesos de Manufactura - IN179 - 202101

Descripción: Tecnología de los Procesos de Manufactura es un curso de especialidad del área de producción, de carácter teórico- práctico, con laboratorio y proyectos que acompañan las clases teóricas, dirigido a los estudiantes del 7° ciclo de la carrera de Ingeniería Industrial. El estudiante desarrolla el pensamiento crítico en la actividad de ingeniería aplicada a la producción de bienes. Se identifican los procesos de manufactura, su aplicación y limitaciones para utilizarlos en el análisis técnico económico y de impacto ecológico, que optimice el proceso garantizando la calidad del producto. Como trabajo de campo, en equipo, se desarrolla un proyecto de fabricación, obteniendo la propuesta dentro del ámbito de la Ingeniería Industrial. Propósito: El Curso de Tecnología de los Procesos de Manufactura permite al estudiante de Ingeniería Industrial desarrollar la competencia para evaluar los procesos de producción, con la finalidad de mejorar la productividad garantizando la calidad del producto. El curso contribuye con el desarrollo de la competencia general de 1Pensamiento crítico a nivel de logro 2 y la competencia específica (Outcome 1) Identifica, formula y resuelve problemas complejos de ingeniería mediante la aplicación de los principios de ingeniería, ciencias y matemáticas, a nivel de logro 2. Cuenta con el requisito de los cursos: IN176 Ciencia y Tecnología de Materiales y IN147 Ingeniería de Método

Impact of anticoagulation therapy on valve haemodynamic deterioration following transcatheter aortic valve replacement.

To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of anticoagulation therapy. This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation therapy was used in 707 patients (28.7%) following TAVR (AC group). A total of 663 patients received vitamin K antagonists, and 44 patients received direct oral anticoagulants. A propensity score matching analysis was performed to adjust for intergroup (AC vs non-AC post-TAVR) differences. A total of 622 patients per group were included in the propensity-matched analysis. VHD was defined as a ≥10 mm Hg increase in the mean transprosthetic gradient at follow-up (vs hospital discharge). The mean clinical follow-up was 29±18 months. The mean transvalvular gradient significantly increased at follow-up in the non-AC group within the global cohort (P=0.003), whereas it remained stable over time in the AC group (P=0.323). The incidence of VHD was significantly lower in the AC group (0.6%) compared with the non-AC group (3.7%, P<0.001), and these significant differences remained within the propensity-matched populations (0.6% vs 3.9% in the AC and non-AC groups, respectively, P<0.001). The occurrence of VHD did not associate with an increased risk of all-cause death (P=0.468), cardiovascular death (P=0.539) or stroke (P=0.170) at follow-up. The lack of anticoagulation therapy post-TAVR was associated with significant increments in transvalvular gradients and a greater risk of VHD. VHD was subclinical in most cases and did not associate with major adverse clinical events. Future randomised trials are needed to determine if systematic anticoagulation therapy post-TAVR would reduce the incidence of VHD