Propuesta de innovaci?n de la actividad administrativa de fiscalizaci?n orientada a mejorar la competitividad del pa?s: el caso del Organismo de Supervisi?n de los Recursos Forestales y de Fauna Silvestre - OSINFOR

Seg?n el World Economic Forum (WEF) y el Institute of Management Development (IMD), el pa?s muestra poco desarrollo de la competitividad. Este aspecto involucra entre otros, al sector forestal y de fauna silvestre. El Organismo de Supervisi?n de los Recursos Forestales y de Fauna Silvestre (OSINFOR) ejerce la potestad fiscalizadora, determina si el aprovechamiento del recurso se realiza conforme a los t?tulos habilitantes y si el producto o esp?cimen es de origen legal. De esta manera, coadyuva a la trazabilidad y seguridad jur?dica en la cadena productiva. A fin de aportar a la gesti?n de la actividad administrativa de fiscalizaci?n del OSINFOR se plantea la presente tesis, cuyo objetivo general es ?Proponer un modelo de gesti?n de la actividad administrativa de fiscalizaci?n del OSINFOR, para contribuir a la mejora de la competitividad del pa?s?. Se realiz? un estudio cualitativo, revisi?n de la normativa nacional e internacional y acad?mica, entrevistas semiestructuradas dirigidas a expertos en el sector, planteamiento de un nuevo modelo de gesti?n, estudio de viabilidad, estimaci?n de los cos tos para la fase previa a la implementaci?n de la propuesta y estimaci?n de su impacto sobre el PBI. Se concluye que la propuesta constituye una innovaci?n en la gesti?n p?blica

LipoDDx: a mobile application for identification of rare lipodystrophy syndromes

BACKGROUND: Lipodystrophy syndromes are a group of disorders characterized by a loss of adipose tissue once other situations of nutritional deprivation or exacerbated catabolism have been ruled out. With the exception of the HIV-associated lipodystrophy, they have a very low prevalence, which together with their large phenotypic heterogeneity makes their identification difficult, even for endocrinologists and pediatricians. This leads to significant delays in diagnosis or even to misdiagnosis. Our group has developed an algorithm that identifies the more than 40 rare lipodystrophy subtypes described to date. This algorithm has been implemented in a free mobile application, LipoDDx(R). Our aim was to establish the effectiveness of LipoDDx(R). Forty clinical records of patients with a diagnosis of certainty of most lipodystrophy subtypes were analyzed, including subjects without lipodystrophy. The medical records, blinded for diagnosis, were evaluated by 13 physicians, 1 biochemist and 1 dentist. Each evaluator first gave his/her results based on his/her own criteria. Then, a second diagnosis was given using LipoDDx(R). The results were analysed based on a score table according to the complexity of each case and the prevalence of the disease. RESULTS: LipoDDx(R) provides a user-friendly environment, based on usually dichotomous questions or choice of clinical signs from drop-down menus. The final result provided by this app for a particular case can be a low/high probability of suffering a particular lipodystrophy subtype. Without using LipoDDx(R) the success rate was 17 +/- 20%, while with LipoDDx(R) the success rate was 79 +/- 20% (p < 0.01). CONCLUSIONS: LipoDDx(R) is a free app that enables the identification of subtypes of rare lipodystrophies, which in this small cohort has around 80% effectiveness, which will be of help to doctors who are not experts in this field. However, it will be necessary to analyze more cases in order to obtain a more accurate efficiency value

Producci?n de leche de cabras alimentadas con (Pennisetum purpureum x P. typhoides), suplementadas con diferentes niveles de follaje de Por? (Erythrina poeppigiana) y de fruto de pl?tano verde (Musa sp. cv. pelipita)

Tesis (M. Sc) -- CATIE; UCR, Turrialba (Costa Rica), 1989El presente estudio se realiz? con el prop?sito de evaluar los efectos de la suplementaci?n de dos niveles de Por? (Erythrina poeppigiana) y pl?tano verde (Musa sp cv. "pelipita") como fuente de prote?na y energ?a respectivamente, sobre la Producci?n de leche de cabras estabuladas y alimentadas con una dieta base de King Grass (Pennisetum purpureum x P. typhoides). Esta investigaci?n se llev? a cabo en la Unidad de Cabras y el Laboratorio de Nutrici?n del Departamento de Producci?n Animal del CATIE, Turrialba, Costa Rica. Se utilizaron doce cabras lactantes distribuidas aleatoriamente en cuatro grupos de animales. Se utiliz? un dise?o experimental de sobrecambio dispuesto como cuadrado latino con per?odo extra bajo un arreglo factorial. La raci?n base consisti? en King Grass (Pennisetum purpureum x P. typhoides) las fuentes de suplementaci?n a comparar fueron dos niveles de pl?tano verde (Musa sp. cv. "pelipita") con dos de por? (Erythrina poeppigiana). Se trabaj? con tres cuadrados dispuestos con cuatro tratamientos y cinco per?odos incluyendo uno extra. Cada per?odo tuvo una duraci?n de 21 d?as. Los primeros 14 d?as fueron de adaptaci?n, tom?ndose los ?ltimos 7 d?as para la toma de datos. La duraci?n total del experimento fue de 11 d?as. Posteriormente al experimento se realiz?, durante 15 d?as, mediante el uso del ?xido de cromio como marcador, una prueba in vivo a las cuatro raciones, para la determinaci?n de la digestibilidad de la materia seca. Las variables estudiadas fueron Producci?n de leche, contenido de grasa en la leche, peso corporal, consumo de alimento y digestibilidad in vivo de la materia seca. Los resultados en Producci?n de leche, indican que existe un efecto significativo de la interacci?n de los efectos de los niveles de por? y de pl?tano verde. Se encontr? la mayor Producci?n de leche (1.27 Kg/animal/d?a) con los niveles mayores de consumo de por? y pl?tano pelipita verde. En relaci?n al porcentaje de grasa en la leche no se encontraron diferencias estad?sticas significativas entre los tratamientos aunque se detect? cierta tendencia positiva (p<0.13) al aumento de grasa (3.45), en el tratamiento con el mayor nivel de por? y pl?tano. La tendencia de los efectos de las raciones en el rendimiento de ganancia de peso tambi?n mostr? tendencia positiva entre los tratamientos (p<0.8). Las cabras ganaron m?s peso conforme aumentaron los niveles de por? y pl?tano en la raci?n. En la prueba de digestibilidad in vivo que se efectu?, se determin? que la materia seca de las raciones con los mayores niveles de pl?tano verde ten?an una mayor digestibilidad (63.1 por ciento) que las raciones con los menores niveles de pl?tano (61.1 por ciento)

Association of smoking with triple concordant seropositivity in RA patients, and with rheumatoid factor in the remaining patients

Background: The contribution of cigarette smoking to the risk of rheumatoid arthritis (RA) is larger for seropositive than for seronegative patients. Current pathogenic models explain this difference via the production of anti-citrullinated protein antibodies (ACPA) induced by protein citrullination in the lungs as a consequence of smoking. However, there are inconsistent results with this model including the van Wesemael et al . report, which found an association of smoking with the concurrent presence of ACPA, rheumatoid factor (RF) and anti-carbamylated protein antibodies (ACarPA), rather than with ACPA. Objectives: We aimed to explore the relationship between smoking and the presence of FR, ACPA and ACarPA and their combinations in patients with RA. Methods: Six cohorts with 2253 RA patients were obtained to replicate the van Wesemael et al . results. After replication, they were combined with the three cohorts from that study comprising 2238 patients to a total of 4491 patients. The results from the different cohorts were combined by fixed-effects meta-analysis. Most analyses involved comparisons between two levels of smoking exposure, never and ever smokers, considering the RF-/ACPA-/ACarP-patients as the reference. Results: Analysis of the replication set confirmed the predominant association of smoking with the concurrent presence of the three RA autoantibodies (OR = 1.99, P = 2.5 x 10-8), whereas the patients with one or two antibodies were not different from the patients without antibodies (OR = 1.22, p = 0.4 and OR = 1.22, p = 0.3, respectively). The combined meta-analysis with all the cohorts clarified the dominant association of smoking with the triple concordant seropositivity (OR = 2.00, p = 4.4 x 10-16). In contrast, there was no association with the patient bearing one autoantibody (OR = 1.12, p = 0.4), and an in-between association with the concurrent presence of two antibodies (OR = 1.26, p = 0.009). Moreover, the association with the presence of three antibodies was significantly larger than with two antibodies (OR = 1.54, p = 1.4 x 10-6), whereas the association with the presence of two antibodies was not larger than with one autoantibody (OR = 1.11, p = 0.3). In the patients remaining after exclusion of the triple seropositive, the smokers were exclusively associated with the RF+ (OR = 1.28, p = 0.03 and OR = 1.30, p = 0.004 in the double and single positive patients, respectively). This association was independent of the reference, either the triple seronegative (OR = 1.29, p = 0.001) or all the RF-patients (OR = 1.32, p = 0.0002). Conclusion: Smoking increases RA susceptibility by promoting pathways leading to the concurrent presence of the three RA autoantibodies and, in its defect, to the production of RF. These actions are not covered by current pathogenic models and suggest that smoking accelerates epitope spread