Diseño y desarrollo de un prototipo de software de sistema de alertas tempranas para la problemática de los arroyos en la ciudad de Barranquilla

Ingeniería de SistemasEl desarrollo de la investigación presenta una aplicación web, en el cual se alerta al ciudadano local sobre los arroyos y su nivel de peligrosidad en la ciudad de Barranquilla. Para el desarrollo del proyecto se utilizó el lenguaje de programación Ruby con el frameworkRails el cual usa como patrón de diseño la arquitectura MVC, la metodología utilizada para el proceso del desarrollo del ciclo de vida del software fue la metodología de Rumbaugh por medio de ella se realizó el proceso de análisis del objeto en donde se plasmó todo el proceso de levantamiento de información y captura de requisitos, el proceso de diseño el cual una vez realizado el levantamiento de información, se realizaron los diagramas de casos de uso y los diagramas de clases para determinar, delimitar y detallar el esquema final del prototipo y por último el proceso de implementación el cual se aplicaron los diagramas realizados y los requisitos funcionales y no funcionales; finalmente se realizan las pruebas de la herramienta para la comprobación funcional de todo el sistema, dando como resultado un prototipo final que permite a los usuarios estar informado de los niveles de peligrosidad que cuentan los arroyos de la ciudad en temporadas invernales.The development of the research presents a web application, which alerts the local citizen on streams and their level of hazard in the city of Barranquilla. For the project the programming language Ruby with the Rails framework which uses as the MVC design pattern architecture was used, the methodology used for the development process of the software life cycle methodology Rumbaugh was through her the scan of the object in which the whole process of information gathering and capture requirements, the design process which once made the information gathering was held was reflected, diagrams and use case diagrams were performed classes to determine, define and detail the final outline of the prototype and finally the implementation process which diagrams made and implemented functional and non-functional requirements; finally testing tool for functional testing of the complete system are made, resulting in a final prototype that allows users to be informed of the danger levels that have streams of the city in winter seasons

Risks of dengue secondary infective biting associated with aedes aegypti in home environments in Monterrey, Mexico

Abstract. Secondary dengue virus infections are a major risk for developing dengue hemorrhagic fever. Recent exposure to infectious bites of Aedes aegypti (L.) females in previously diagnosed dengue cases fulfills the epidemiological model of dengue hemorrhagic fever. A study was comprised of 357 (89.2%) dengue and 43 (10.8%) dengue hemorrhagic fever cases confirmed by laboratory tests and clinical manifestations. An entomological survey was done in homes and backyards. Concurrently, a questionnaire was used to assess the impact of healthpromotion campaigns through knowledge of the vector and its epidemiological role. Seventy-six (28.4%) of the 268 (67.0%) total wet or dry oviposition sites were positive for the presence of larvae or pupae, while adult Ae. aegypti were found in 32 (8.0%). One hundred thirty-two (33%) householders who formerly had dengue fever or dengue hemorrhagic fever had knowledge of either larval or adult dengue vector stages. According to gender distribution, 145 (36.2%) and 14 (3.5%) of the males confirmed with cases of dengue and dengue hemorrhagic fever lived in houses with 17.9 and 2% of the Ae. aegypti larval and pupal habitats. Houses with females who had dengue and dengue hemorrhagic fever were 212 (53%) and 29 (7.3%), with containers with immature Ae. aegypti in 19.4 and 7%, respectively. Lack of sustainability of government-targeted health education campaigns is the major problem for involving communities in prevention and control of dengu

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Seguridad Ciudadana: Visiones compartidas

Desde su origen, el gobierno tiene como objeto principal de su existencia la protección de la vida y los bienes de sus ciudadanos. Así lo describe, entre otros muchos pensadores, Juan Jacobo Rousseau en su clásica obra: “El Contrato Social”. En los últimos años como consecuencia del incremento de delitos, de la inseguridad pública, esta atribución y obligación del Gobierno ha destacado como uno de los temas relevantes de Administración Pública: la “Seguridad Ciudadana”. Como sabemos el Estado es permanente, en tanto el gobierno cambia, precisamente para adaptar sus órganos ejecutores conforme a las necesidades de su población y los cambios en su espacio y territorio. La obra que hoy edita el Instituto de Administración Pública del Estado de México, A. C. constituye un esfuerzo de sus autores para contribuir con su información, sus propuestas y sus conclusiones a mejorar la percepción y la realidad de la lucha contra la delincuencia, sus resultados y para aumentar la seguridad ciudadana.Esta publicación presenta un balance de la discusión y el conocimiento acumulado sobre el tema de la seguridad vinculado al Estado de derecho y, actualmente, al nuevo paradigma de la seguridad y los derechos humanos, la función policial y las investigaciones en torno al origen de la conducta delictiva que, en conjunto, han dado pie a la construcción del concepto de seguridad ciudadana. El objetivo es retomar planteamientos teóricos y prácticos sobre el tema, a partir de múltiples disciplinas, estudios y análisis de caso. La revisión crítica a cargo de los autores del proyecto Seguridad Ciudadana: visiones compartidas, parte de una meta ambiciosa: abonar a la construcción de ciudadanía para rescatar la legitimidad del Estado mediante la promoción de prácticas democráticas en las políticas públicas relativas a la seguridad. Asimismo, el trabajo responde al interés creciente de la población y los actores gubernamentales de entender el fenómeno social transversal que estamos viviendo caracterizado por el incremento de los distintos tipos de violencia, que exige un análisis más detallado de sus causas y naturaleza. De igual forma, los textos incluidos ofrecen información y evidencias empíricas que permiten elaborar diversas hipótesis y argumentar a favor o en contra de las políticas aplicadas para combatir la delincuencia

Incidence, Clinical Characteristics, and Management of Psoriasis Induced by Anti-TNF Therapy in Patients with Inflammatory Bowel Disease: A Nationwide Cohort Study.

Psoriasis induced by anti-tumor necrosis factor-α (TNF) therapy has been described as a paradoxical side effect. To determine the incidence, clinical characteristics, and management of psoriasis induced by anti-TNF therapy in a large nationwide cohort of inflammatory bowel disease patients. Patients with inflammatory bowel disease were identified from the Spanish prospectively maintained Estudio Nacional en Enfermedad Inflamatoria Intestinal sobre Determinantes genéticos y Ambientales registry of Grupo Español de Trabajo en Enfermedad de Croh y Colitis Ulcerosa. Patients who developed psoriasis by anti-TNF drugs were the cases, whereas patients treated with anti-TNFs without psoriasis were controls. Cox regression analysis was performed to identify predictive factors. Anti-TNF-induced psoriasis was reported in 125 of 7415 patients treated with anti-TNFs (1.7%; 95% CI, 1.4-2). The incidence rate of psoriasis is 0.5% (95% CI, 0.4-0.6) per patient-year. In the multivariate analysis, the female sex (HR 1.9; 95% CI, 1.3-2.9) and being a smoker/former smoker (HR 2.1; 95% CI, 1.4-3.3) were associated with an increased risk of psoriasis. The age at start of anti-TNF therapy, type of inflammatory bowel disease, Montreal Classification, and first anti-TNF drug used were not associated with the risk of psoriasis. Topical steroids were the most frequent treatment (70%), achieving clinical response in 78% of patients. Patients switching to another anti-TNF agent resulted in 60% presenting recurrence of psoriasis. In 45 patients (37%), the anti-TNF therapy had to be definitely withdrawn. The incidence rate of psoriasis induced by anti-TNF therapy is higher in women and in smokers/former smokers. In most patients, skin lesions were controlled with topical steroids. More than half of patients switching to another anti-TNF agent had recurrence of psoriasis. In most patients, the anti-TNF therapy could be maintained

Novel genes and sex differences in COVID-19 severity.

Here we describe the results of a genome-wide study conducted in 11 939 COVID-19 positive cases with an extensive clinical information that were recruited from 34 hospitals across Spain (SCOURGE consortium). In sex-disaggregated genome-wide association studies for COVID-19 hospitalization, genome-wide significance (p < 5x10-8) was crossed for variants in 3p21.31 and 21q22.11 loci only among males (p = 1.3x10-22 and p = 8.1x10-12, respectively), and for variants in 9q21.32 near TLE1 only among females (p = 4.4x10-8). In a second phase, results were combined with an independent Spanish cohort (1598 COVID-19 cases and 1068 population controls), revealing in the overall analysis two novel risk loci in 9p13.3 and 19q13.12, with fine-mapping prioritized variants functionally associated with AQP3 (p = 2.7x10-8) and ARHGAP33 (p = 1.3x10-8), respectively. The meta-analysis of both phases with four European studies stratified by sex from the Host Genetics Initiative confirmed the association of the 3p21.31 and 21q22.11 loci predominantly in males and replicated a recently reported variant in 11p13 (ELF5, p = 4.1x10-8). Six of the COVID-19 HGI discovered loci were replicated and an HGI-based genetic risk score predicted the severity strata in SCOURGE. We also found more SNP-heritability and larger heritability differences by age (<60 or ≥ 60 years) among males than among females. Parallel genome-wide screening of inbreeding depression in SCOURGE also showed an effect of homozygosity in COVID-19 hospitalization and severity and this effect was stronger among older males. In summary, new candidate genes for COVID-19 severity and evidence supporting genetic disparities among sexes are provided