Climate change, site formation, and indigenous use of coastlines in Barbuda

This article explores the landscape dynamics at the island of Barbuda in the context of changing climate to understand (1) the environmental setting of indigenous settlements; (2) the impacts of current coastal processes; and (3) the potential threats moving forward toward increasing pressure of climate change. Focusing on the site of Seaview, on the east coast of Barbuda, we use geoarchaeological methods to reconstruct the ancient geomorphological setting, investigate changes post-abandonment, and identify the hazards faced under future sea-level projections. Our study shows that (1) sea level stabilization after the Mid-Holocene allowed the formation of coral reefs, seagrass beds and other benthic ecosystems that allowed for biogenic sediment accumulation and growth of sand dune retention ridges. (2) These environmental characteristics, including rich marine food sources, supported the establishment and flourishing of Seaview starting ca. 160 BC. (3) Occupation ended at some point between AD960 and 1000. This change coincided with a period of increased storminess, higher SSTs, and possible coral reef mortality that affected both food availability and sediment supply. (4) Lack of sediments triggered progressive sand dune erosion that continues today and has left the sand dune ridge past the tipping point of erosion. (5) Looking into a future of rapidly changing climate, sea level rise poses a severe and devastating threat to the land- and seascapes of Barbuda. With the lowland coastal plain at or only slightly above current sea level, a rate of SLR comparable to Mid-Holocene rates, and rapid loss of sand dune ridges and coral reefs as natural barriers, it is just a matter of time before the lowlands become transformed beyond recognition. The results of this analysis can be used to improve long-term management of the heritage resources of Barbudans and shed light on parallel challenges experienced on other tropical coastal locations

Validez diagnóstica de los predictores clínicos preoperatorios de asge y chisholm para coledocolitiasis en pacientes con diagnóstico de colecistitis litiásica del hospital Alta Complejidad Virgen de la Puerta

Determinar la validez diagnóstica del score predictivo preoperatorio de ASGE frente al score CHISHOLM para coledocolitiasis en pacientes diagnosticados de colecistitis litiásica en “Hospital De Alta Complejidad Virgen De La Puerta – EsSalud”. Materiales y Métodos: Se realizó un estudio observacional, analítico, retrospectivo de tipo prueba diagnósticas en pacientes con colecistitis litiásica atendidas en el Hospital De Alta Complejidad Virgen De La Puerta – EsSalud” en el periodo enero del 2019 a diciembre del 2023. Se registró de las historias clínicas a todos los pacientes con Coledocolitiasis diagnosticados por colangioresonancia magnética, siendo evaluados con ambos scores predictores de Asge y Chisholm, para así poder distinguir cual score tiene mayor predicción. Se analizó la sensibilidad, la especificidad, el valor predictivo positivo, el valor predictivo negativo de ambos scores predictores. Resultados: Participaron 225 pacientes con Colecistitis Litiásica, de los cuales 32 (14.2%) tuvieron coledocolitiasis por colangioresonancia magnética. La sensibilidad, especificidad, valor predictivo positivo y negativo del score predictivo preoperatorio de coledocolitiasis de la ASGE en pacientes con colecistitis litiásica es 90.6%, 46.70%, 81.77% y 65.91% respectivamente. La especificidad, la sensibilidad, valor predictivo positivo y negativo del score predictivo preoperatorio de coledocolitiasis de Chisholm en pacientes con colecistitis litiásica es 82.20%, 70.90%, 88.16% y 60.27% respectivamente, tras comparar ambos resultados observamos que mayor Índice de validez la obtuvo Score Chisholm con 79,11% asimismo la razón de verosimilitud positiva más alta la obtuvo el score Chisholm con 2,83%. Las variables intervinientes asociadas al diagnóstico de coledocolitiasis fueron: el diámetro colédoco según ecografía mayor o igual a 6 mm (p < 0,05), el sexo femeninoen un 62.5% (p <0,05). Conclusiones: El Score CHISHOLM tiene mayor validez de pronóstico que el Score ASGE para el diagnóstico de coledocolitiasis en pacientes con colecistitis litiásica.To determine the diagnostic validity of the ASGE preoperative predictive score versus the CHISHOLM score for choledocholithiasis in patients diagnosed with calculous cholecystitis in ‘Hospital De Alta Complejidad Virgen De La Puerta – EsSalud¨. Materials and Methods: An observational, analytical, retrospective study of diagnostic test type was conducted in patients with calculous cholecystitis treated at the ‘Hospital De Alta Complejidad Virgen De La Puerta - EsSalud’ in the period January 2019 to December 2023. All patients with choledocholithiasis diagnosed by magnetic resonance cholangiography were registered in the medical records and evaluated with both Asge and Chisholm predictor scores, in order to distinguish which score is more predictive. Sensitivity, specificity, positive predictive value and negative predictive value of both predictor scores were analysed . Results: 225 patients with calculous cholecystitis participated, of which 32 (14.2%) had choledocholithiasis by magnetic resonance cholangiography. The sensitivity, specificity, positive predictive value and negative predictive value of the ASGE preoperative choledocholithiasis predictive score in patients with calculous cholecystitis are 90.6%, 46.70%, 81.77% and 65.91% respectively. The specificity, sensitivity, positive and negative predictive value of the Chisholm preoperative predictive score for choledocholithiasis in patients with calculous cholecystitis is 82.20%, 70.90%, 88.16% and 60.27% respectively. After comparing both results, we observed that the highest validity index was obtained by the Chisholm score with 79.11% and the highest positive likelihood ratio was obtained by the Chisholm score with 2.83%. The intervening variables associated with the diagnosis of choledocholithiasis were: common bile duct diameter greater than or equal to 6 mm according to ultrasound (p < 0.05), female sex 62.5% (p < 0.05) . Conclusions: The CHISHOLM Score has greater prognostic validity than the ASGE Score for the diagnosis of choledocholithiasis in patients with calculous cholecystitisTesi

Guía de diseño para la construcción de pavimentos portuarios de uso comercial, según la asociación británica de puertos (BPA) y recomendaciones para obras marítimas (ROM)

En la presente investigación, se elaboró una guía de diseño para pavimentos portuarios de uso comercial para su uso en el campo pedagógico e ingenieril, basada en las normas British Ports Association (BPA) y Recomendaciones para Obras Marítimas (ROM). La investigación fue descriptiva, deductivo, enfoque cuantitativo, orientación deductiva y aplicativa, y diseño experimental. La población y muestra de estudio se limita a las investigaciones relacionadas a esta investigación. En esta investigación se realizó el análisis de las mallas curriculares, plan de estudios y sílabos de universidades peruanas para comprobar la ausencia del curso de Diseño de Pavimentos Portuarios; con el fin de justificar la necesidad de proponer una guía. Se logró la elaboración de la guía mediante la revisión y análisis de las normas base, sumado a otras fuentes y estudios. Posteriormente, se realizó un diseño de pavimento portuario en un suelo del Puerto de Ilo, obteniendo un diseño funcional y similar a los diseñados por las mismas entidades autoras de las normas base. Comprobando y demostrando la hipótesis general de la investigación. Concluyendo, la necesidad de una guía de diseño para el uso pedagógico e ingenieril de los profesionales de la carrera de Ingeniería Civil y futuras obras portuarias

Emprendimiento Social para generar empleo a inmigrantes hispanos

Trámites y soluciones “Web servicios”. Mapa de ideas de los servicios que ofrece,Link de la Página Facebook https://www.facebook.com/pg/WebServices104537114584404/posts/?ref=page_internal .En busca de mejorar la calidad de vida propia y la de sus familias, son millones de inmigrantes hispanos que emprende su viaje hacia EE.UU con la ilusión de lograr el sueño americano. El Barrio de Corona ubicado en el condado de Queens es el lugar de mayor afluencia de llegada de inmigrantes hispanos, esto lo ha convertido en un sector que alberga una población multicultural. Muchos de los inmigrantes son personas que no cuentan con la documentación en regla, también se les dificulta el dominio del idioma, en muchos casos las personas no han culminados sus estudios de primaria ni bachiller, debido a esto esta población carece de oportunidades y garantías laborales, convirtiéndose esta situación en una problemática social. Con el fin de dar solución a la problemática social detectada en la población de inmigrantes hispanos que residen en Corona Queens, es necesario analizar la viabilidad del proyecto de emprendimiento social propuesto con el que se pretende minimizar o solucionar la problemática social de los inmigrantes hispanos. Web Servicios, es una página web, en el cual se ofrecen distintos servicios, con este modelo de emprendimiento social se busca dar solución a la problemática detectada, durante la implementación del proyecto de emprendimiento social, fue necesario de realizar la ejecución de una secuencia de fases, en este documento se agrupara todo el proceso y en él se describirán cada una de las fases realizadas, iniciando con el análisis de la situación actual social, definición de la problemática social, acciones de innovación social, Design Thinking, estrategias de mercadeo y por último diseñar diferentes programas de marketing digital.In search of improving the quality of life for themselves and their families, there are millions of Hispanic immigrants who undertake their journey to the US with the hope of achieving the dream American. The Corona Neighborhood located in Queens County is the largest influx of arrival of Hispanic immigrants, this has made it a sector that houses a multicultural population. Many of the immigrants are people who do not have the documentation in order, it is also difficult for them to master the language, in many cases the people have not completed their elementary or high school studies, due to this this population lacks opportunities and labor guarantees, turning this situation into a social problem. In order to provide a solution to the social problems detected in the population of Hispanic immigrants residing in Corona Queens, it is necessary to analyze the viability of proposed social entrepreneurship project with which it is intended to minimize or solve the social problems of Hispanic immigrants. Web Services, is a web page, in which different services are offered, with this social entrepreneurship model seeks to provide a solution to the problems detected, During the implementation of the social entrepreneurship project, it was necessary to perform the execution of a sequence of phases, in this document all the process and it will describe each of the phases carried out, beginning with the analysis of the current social situation, definition of social problems, innovation actions social, Design Thinking, marketing strategies and finally design different digital marketing programs

The climate-smart village approach: Framework of an integrative strategy for scaling up adaptation options in agriculture

Increasing weather risks threaten agricultural production systems and food security across the world. Maintaining agricultural growth while minimizing climate shocks is crucial to building a resilient food production system and meeting developmental goals in vulnerable countries. Experts have proposed several technological, institutional, and policy interventions to help farmers adapt to current and future weather variability and to mitigate greenhouse gas (GHG) emissions. This paper presents the climate-smart village (CSV) approach as a means of performing agricultural research for development that robustly tests technological and institutional options for dealing with climatic variability and climate change in agriculture using participatory methods. It aims to scale up and scale out the appropriate options and draw out lessons for policy makers from local to global levels. The approach incorporates evaluation of climate-smart technologies, practices, services, and processes relevant to local climatic risk management and identifies opportunities for maximizing adaptation gains from synergies across different interventions and recognizing potential maladaptation and trade-offs. It ensures that these are aligned with local knowledge and link into development plans. This paper describes early results in Asia, Africa, and Latin America to illustrate different examples of the CSV approach in diverse agroecological settings. Results from initial studies indicate that the CSV approach has a high potential for scaling out promising climate-smart agricultural technologies, practices, and services. Climate analog studies indicate that the lessons learned at the CSV sites would be relevant to adaptation planning in a large part of global agricultural land even under scenarios of climate change. Key barriers and opportunities for further work are also discussed

Atlas of group A streptococcal vaccine candidates compiled using large-scale comparative genomics.

Group A Streptococcus (GAS; Streptococcus pyogenes) is a bacterial pathogen for which a commercial vaccine for humans is not available. Employing the advantages of high-throughput DNA sequencing technology to vaccine design, we have analyzed 2,083 globally sampled GAS genomes. The global GAS population structure reveals extensive genomic heterogeneity driven by homologous recombination and overlaid with high levels of accessory gene plasticity. We identified the existence of more than 290 clinically associated genomic phylogroups across 22 countries, highlighting challenges in designing vaccines of global utility. To determine vaccine candidate coverage, we investigated all of the previously described GAS candidate antigens for gene carriage and gene sequence heterogeneity. Only 15 of 28 vaccine antigen candidates were found to have both low naturally occurring sequence variation and high (>99%) coverage across this diverse GAS population. This technological platform for vaccine coverage determination is equally applicable to prospective GAS vaccine antigens identified in future studies

Impact on mortality and cancer incidence rates of using random invitation from population registers for recruitment to trials

Background: Participants in trials evaluating preventive interventions such as screening are on average healthier than the general population. To decrease this 'healthy volunteer effect' (HVE) women were randomly invited from population registers to participate in the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) and not allowed to self refer. This report assesses the extent of the HVE still prevalent in UKCTOCS and considers how certain shortfalls in mortality and incidence can be related to differences in socioeconomic status.Methods: Between 2001 and 2005, 202 638 postmenopausal women joined the trial out of 1 243 312 women randomly invited from local health authority registers. The cohort was flagged for deaths and cancer registrations and mean follow up at censoring was 5.55 years for mortality, and 2.58 years for cancer incidence. Overall and cause-specific Standardised Mortality Ratios (SMRs) and Standardised Incidence Ratios (SIRs) were calculated based on national mortality (2005) and cancer incidence (2006) statistics. The Index of Multiple Deprivation (IMD 2007) was used to assess the link between socioeconomic status and mortality/cancer incidence, and differences between the invited and recruited populations.Results: The SMR for all trial participants was 37%. By subgroup, the SMRs were higher for: younger age groups, extremes of BMI distribution and with each increasing year in trial. There was a clear trend between lower socioeconomic status and increased mortality but less pronounced with incidence. While the invited population had higher mean IMD scores (more deprived) than the national average, those who joined the trial were less deprived.Conclusions: Recruitment to screening trials through invitation from population registers does not prevent a pronounced HVE on mortality. The impact on cancer incidence is much smaller. Similar shortfalls can be expected in other screening RCTs and it maybe prudent to use the various mortality and incidence rates presented as guides for calculating event rates and power in RCTs involving women