Conocimientos y prácticas del personal de enfermería en atención a pacientes con crisis convulsivas en el servicio de Emergencia, Hospital Infantil Manuel de Jesús Rivera, II semestre 2016

El presente estudio es cuantitativo , descriptivo , prospectivo y de corte transversal fue realizado en el Hospital Infantil Manuel de Jesús Rivera con el personal de enfermería que labora en el servicio de emergencias nuestra población estuvo conformada por 22 recursos siendo esta misma la muestra ; las técnicas e instrumentos que se utilizaron fueron guía de encuesta estructurada con 25 preguntas aplicada a todos los participantes siendo determinante para conocer las características sociodemográficas y laborales, determinar el conocimiento de esta población también se utilizó guía de observación directa no participativa observando las acciones que realiza el personal de enfermería durante la atención a pacientes con crisis convulsiva que acudieron a esta unidad hospitalaria. Según el estudio realizado con tema conocimientos y prácticas de enfermería en atención de pacientes con crisis convulsiva en las características sociodemográficas encontramos que el grupo de edad con mayor predominio fue entre las edades de 25 – 34 años el sexo con mayor predominio fue el femenino, en las características laborales encontramos que 6 trabajadores tienen de 6 – 10 años de laborar en la institución, 9 recursos tienen de 1 – 5 años de laborar en emergencia, 11 recursos realizan de 4 – 8 turnos al mes, 8 recursos realizan turnos de 24 horas, 15 recursos de enfermería refirieron no haber recibido ninguna capacitación sobre crisis convulsiva. El conocimiento que tiene este personal se encuentra en la escala de muy bueno porque 12 recursos respondieron de 14 – 19 preguntas correctamente sobre la temática de crisis convulsiva, siguiendo la escala de excelente con 9 recursos que respondieron de 20 – 25 preguntas correctamente. La práctica que tienen estos recursos se encuentra en la escala por mejorar porque 10 recursos de 16 observados realizan menos de 10 pasos fundamentales durante la atención de paciente y solo 6 recursos realizaron las acciones completa

WO3/TiO2 nanotube photoanodes for solar water splitting with simultaneous wastewater treatment.

Nanostructured WO3/TiO2 nanotubes with properties that enhance solar photoconversion reactions were developed, characterized and tested. The TiO2 nanotubes were prepared by anodization of Ti foil, and WO3 was electrodeposited on top of the nanotubes. SEM images show that these materials have the same ordered structure as TiO2 nanotubes, with an external nanostructured WO3 layer. Diffuse reflectance spectra showed an increase in the visible absorption relative to bare TiO2 nanotubes, and in the UV absorption relative to bare WO3 films. Incident simulated solar photon-to-current efficiency increased from 30% (for bare WO3) to 50% (for WO3/TiO2 composites). With the addition of diverse organic pollutants, the photocurrent densities exhibited more than a 5-fold increase. Chemical oxygen demand measurements showed the simultaneous photodegradation of organic pollutants. The results of this work indicate that the unique structure and composition of these composite materials enhance the charge carrier transport and optical properties compared with the parent materials

Propuesta de un modelo de gestión de riesgo crediticio para el mejoramiento de la administración de los microcréditos en la Cooperativa ACOACAC de R. L

Los riesgos en la actualidad son una parte fundamental que toda institución debe evaluar, por lo cual surge la presente investigación como respuesta a la necesidad de implementar un “Modelo de Gestión de Riesgo crediticio para el mejoramiento de la Administración de los Microcréditos de la Cooperativa ACOACAC de R.L” El objetivo de este estudio es el de facilitar la comprensión y aplicación de un diseño de gestión de riesgo de crédito a través de análisis de los estados financieros, proporcionando así una herramienta práctica y sencilla que permita a la cooperativa implementar procedimientos adecuados para identificar, medir, controlar, mitigar, monitorear y comunicar los riesgos de los Microcréditos asociados con la cooperativa , los cuales al ser ejecutados correctamente ayudarán a encontrar soluciones reales y prácticas. Con los resultados obtenidos por medio de la encuesta, la entrevista y la observación se lograron determinar que la Cooperativa ACOACAC de R.L no cuenta con los conocimientos necesarios para implementar un modelo de gestión de riesgo crediticio, y que para llevarlo a cabo se requiere establecer políticas y procedimientos adecuados a las actividades que se realizan. Es por ello que se establecen los elementos con los que cuenta la Cooperativa así como los que requiere y necesita tener ya que con ello se valorará el riesgo, los procedimientos para la implementación de dicho modelo a la hora de promover un microcrédito. Además de ello se determinará el impacto y la probabilidad en el cual un riesgo pueda tener incidencia negativa o positiva dentro de la cooperativa y con ello poder clasificar el tipo de riesgos y así poder identificarlo y medirlo. Así mismo se elaborará una matriz de riesgo o mapa de calor el cual mostrará el riesgo más vulnerable y con ello poder establecer diferentes estrategias entre ellos, los límites de otorgamiento, consideración de garantías, monitoreo y gestiones que se pueden implementar para la recuperación de los microcréditos así como la implementación de políticas. La Cooperativa ACOACAC de R.L tiene como actividad económica principal la captación y colocación de fondos en diferentes tipos de crédito a la población a fin de contribuir con el mejoramiento económico así como la satisfacción de necesidades crediticias. Es por ello que se cuenta con los siguientes elementos: a) Misión Somos una Asociación Cooperativa, de solidó prestigio dedicada a la prestación de servicios financieros de ahorro y crédito de forma inmediata, transparente y oportuna, mediante la amabilidad, responsabilidad y experiencia del personal; con la finalidad de impulsar el desarrollo económico y social de sus asociados (as) en toda la Zona Oriental. b) Visión Ser una Asociación Cooperativa, de expansión sólida en toda la Zona Oriental, en la prestación de servicios diversificados; ahorro, crédito, remesas familiares y servicios de pago de energía eléctrica, etc. Mediante la eficiencia y eficacia del personal operativo y administrativo. c) Estructura Organizativa La Cooperativa ACOACAC de R.L no cuenta con una estructura organizativa, en la cual se requiera un ordenamiento jerárquico que especifique la función que cada uno debe ejecuta

Theoretical and experimental studies of electrified interfaces relevant to energy storage

Advances in technology for electrochemical energy storage require increased understanding of electrolyte/electrode interfaces, including the electric double layer structure, and processes involved in charging of the interface, and the incorporation of this understanding into quantitative models. Simplified models such as Helmholtz's electric double-layer (EDL) concept don't account for the molecular nature of ion distributions, solvents, and electrode surfaces and therefore cannot be used in predictive, high-fidelity simulations for device design. This report presents theoretical results from models that explicitly include the molecular nature of the electrical double layer and predict critical electrochemical quantities such as interfacial capacitance. It also describes development of experimental tools for probing molecular properties of electrochemical interfaces through optical spectroscopy. These optical experimental methods are designed to test our new theoretical models that provide descriptions of the electric double layer in unprecedented detail

The bHLH transcription factor SPATULA enables cytokinin signaling, and both activate auxin biosynthesis and transport genes at the medial domain of the gynoecium

[EN] Fruits and seeds are the major food source on earth. Both derive from the gynoecium and, therefore, it is crucial to understand the mechanisms that guide the development of this organ of angiosperm species. In Arabidopsis, the gynoecium is composed of two congenitally fused carpels, where two domains: medial and lateral, can be distinguished. The medial domain includes the carpel margin meristem (CMM) that is key for the production of the internal tissues involved in fertilization, such as septum, ovules, and transmitting tract. Interestingly, the medial domain shows a high cytokinin signaling output, in contrast to the lateral domain, where it is hardly detected. While it is known that cytokinin provides meristematic properties, understanding on the mechanisms that underlie the cytokinin signaling pattern in the young gynoecium is lacking. Moreover, in other tissues, the cytokinin pathway is often connected to the auxin pathway, but we also lack knowledge about these connections in the young gynoecium. Our results reveal that cytokinin signaling, that can provide meristematic properties required for CMM activity and growth, is enabled by the transcription factor SPATULA (SPT) in the medial domain. Meanwhile, cytokinin signaling is confined to the medial domain by the cytokinin response repressor ARABIDOPSIS HISTIDINE PHOSPHOTRANSFERASE 6 (AHP6), and perhaps by ARR16 (a type-A ARR) as well, both present in the lateral domains (presumptive valves) of the developing gynoecia. Moreover, SPT and cytokinin, probably together, promote the expression of the auxin biosynthetic gene TRYPTOPHAN AMINOTRANSFERASE OF ARABIDOPSIS 1 (TAA1) and the gene encoding the auxin efflux transporter PIN-FORMED 3 (PIN3), likely creating auxin drainage important for gynoecium growth. This study provides novel insights in the spatiotemporal determination of the cytokinin signaling pattern and its connection to the auxin pathway in the young gynoecium.IRO, VMZM, HHU and PLS were supported by the Mexican National Council of Science and Technology (CONACyT) with a PhD fellowship (210085, 210100, 243380 and 219883, respectively). Work in the SDF laboratory was financed by the CONACyT grants CB-2012-177739, FC-2015-2/1061, and INFR-2015-253504, and NMM by the CONACyT grant CB-2011-165986. SDF, CF and LC acknowledge the support of the European Union FP7-PEOPLE-2009-IRSES project EVOCODE (grant no. 247587) and H2020-MSCARISE-2015 project ExpoSEED (grant no. 691109). SDF also acknowledges the Marine Biological Laboratory (MBL) in Woods Hole for a scholarship for the Gene Regulatory Networks for Development Course 2015 (GERN2015). IE acknowledges the International European Fellowship-METMADS project and the Universita degli Studi di Milano (RTD-A; 2016). Research in the laboratory of MFY was funded by NSF (grant IOS-1121055), NIH (grant 1R01GM112976-01A1) and the Paul D. Saltman Endowed Chair in Science Education (MFY). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Reyes Olalde, J.; Zuñiga, V.; Serwatowska, J.; Chávez Montes, R.; Lozano-Sotomayor, P.; Herrera-Ubaldo, H.; Gonzalez Aguilera, K.... (2017). The bHLH transcription factor SPATULA enables cytokinin signaling, and both activate auxin biosynthesis and transport genes at the medial domain of the gynoecium. PLoS Genetics. 13(4):1-31. https://doi.org/10.1371/journal.pgen.1006726S131134Reyes-Olalde, J. I., Zuñiga-Mayo, V. M., Chávez Montes, R. A., Marsch-Martínez, N., & de Folter, S. (2013). Inside the gynoecium: at the carpel margin. Trends in Plant Science, 18(11), 644-655. doi:10.1016/j.tplants.2013.08.002Alvarez-Buylla, E. 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Territorios sustentables en contexto de pandemia

La obra ofrece trabajos que brindan un conocimiento científico sobre el impacto de la pandemia en la salud, la economía, el ambiente y los territorios y se plantean desafíos para hacer más sostenible la vida en las ciudades y en el campo para insertarse y poder competir a nivel global

Reinfecção da Covid-19 em neonatos e crianças: revisão de literatura : Reinfection of Covid-19 in neonates and children: literature review

Em dezembro de 2019, um novo vírus respiratório foi detectado na China, sendo denominado posteriormente como COVID-19, provindo do vírus SARS-CoV-2. Este vírus se espalhou rapidamente gerando uma pandemia mundial. Vários foram e ainda são os problemas decorrentes deste vírus, que atingiu desde crianças aos idosos, dentre eles, cita-se a reinfeção dos indivíduos, causando como consequência, problemas de saúde inacabáveis. Assim, devido aos estudos elencarem menores sinais e sintomas nas crianças e, ainda, menores taxas de infecção, passou-se a questionar quanto as reinfecções em crianças e neonatos. Por isso, o estudo objetivou realizar uma revisão de literatura sobre reinfecção de COVID-19 em crianças e neonatos. Para isso, realizou-se uma revisão sistemática de literatura, através de uma busca nas bases de dados Latino-Americana e do Caribe em Ciências da Saúde, Google Scholar e Scientific Electronic Library Online, utilizando-se os descritores: Reinfecção COVID-19; Reinfecção COVID-19 em crianças; Reinfecção COVID-19 em neonatos; COVID-19 e reinfecção. Com isso, foram selecionados 10 artigos que compunham os critérios de inclusão e exclusão do presente estudo. Dessa forma, destaca-se que os estudos evidenciaram que o número de reinfecções em crianças e neonatos é baixo, porém, são escassas as literaturas sobre o tema, possuindo, assim diversas lacunas a serem sanadas para uma compreensão melhor do assunto

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Evaluation of factors leading to poor outcomes for pediatric acute lymphoblastic leukemia in Mexico: a multi-institutional report of 2,116 patients

Background and aimsPediatric acute lymphoblastic leukemia (ALL) survival rates in low- and middle-income countries are lower due to deficiencies in multilevel factors, including access to timely diagnosis, risk-stratified therapy, and comprehensive supportive care. This retrospective study aimed to analyze outcomes for pediatric ALL at 16 centers in Mexico.MethodsPatients <18 years of age with newly diagnosed B- and T-cell ALL treated between January 2011 and December 2019 were included. Clinical and biological characteristics and their association with outcomes were examined.ResultsOverall, 2,116 patients with a median age of 6.3 years were included. B-cell immunophenotype was identified in 1,889 (89.3%) patients. The median white blood cells at diagnosis were 11.2.5 × 103/mm3. CNS-1 status was reported in 1,810 (85.5%), CNS-2 in 67 (3.2%), and CNS-3 in 61 (2.9%). A total of 1,488 patients (70.4%) were classified as high-risk at diagnosis. However, in 52.5% (991/1,889) of patients with B-cell ALL, the reported risk group did not match the calculated risk group allocation based on National Cancer Institute (NCI) criteria. Fluorescence in situ hybridization (FISH) and PCR tests were performed for 407 (19.2%) and 736 (34.8%) patients, respectively. Minimal residual disease (MRD) during induction was performed in 1,158 patients (54.7%). The median follow-up was 3.7 years. During induction, 191 patients died (9.1%), and 45 patients (2.1%) experienced induction failure. A total of 365 deaths (17.3%) occurred, including 174 deaths after remission. Six percent (176) of patients abandoned treatment. The 5-year event-free survival (EFS) was 58.9% ± 1.7% for B-cell ALL and 47.4% ± 5.9% for T-cell ALL, while the 5-year overall survival (OS) was 67.5% ± 1.6% for B-cell ALL and 54.3% ± 0.6% for T-cell ALL. The 5-year cumulative incidence of central nervous system (CNS) relapse was 5.5% ± 0.6%. For the whole cohort, significantly higher outcomes were seen for patients aged 1–10 years, with DNA index >0.9, with hyperdiploid ALL, and without substantial treatment modifications. In multivariable analyses, age and Day 15 MRD continued to have a significant effect on EFS.ConclusionOutcomes in this multi-institutional cohort describe poor outcomes, influenced by incomplete and inconsistent risk stratification, early toxic death, high on-treatment mortality, and high CNS relapse rate. Adopting comprehensive risk-stratification strategies, evidence-informed de-intensification for favorable-risk patients and optimized supportive care could improve outcomes