Violines caucanos: tejido territorial rural-urbano en el norte del Cauca y la ciudad-región de Cali (Colombia)

En el suroccidente colombiano, y en particular entre el norte del Cauca y el sur del Valle, incluyendo el municipio de Buenaventura, con Santiago de Cali como el principal epicentro urbano, se encuentra un amplío entramado de relaciones sociales y vínculos rurales-urbanos que se han consolidado en la región a través de una historia común y un desarrollo socioeconómico y cultural compartido, los cuales conforman un importante tejido territorial. Con un fuerte componente racial en su composición demográfica, este es uno de los territorios de mayor diversidad cultural del país, que se enriquece con expresiones de gran importancia, como las músicas negras andinas en interacción con la música indígena y campesina mestiza andina alrededor de los violines caucanos o violines negros, representativos de las comunidades afro caucanas y del sur del Valle. El presente texto hace visible el tejido territorial de la música nortecaucana, con sus agrupaciones de violines caucanos que se han fortalecido gracias al impulso del Festival de Música del Pacífico Petronio Álvarez, cuyo epicentro de realización cada año es Santiago de Cali.Resumen .-- Introducción .-- I. Santiago de Cali, ciudad región .-- II. El Festival de Música del Pacífico Petronio Álvarez .-- III. Clúster musical y patrimonio cultural inmaterial en el norte del Cauca .-- IV. Conclusiones

Alianzas académicas en el contexto de ciudad-región

394 páginas : imágenes, gráficos, tablas ; 28 cm.La Reserva Forestal Thomas van der Hammen representa la alternativa política, económica, ecológica y social de reconstrucción de un espacio natural, que ha sido intervenido constantemente por acciones antrópicas. Por tal razón, este libro tiene como fin presentar todos los aspectos relacionados con la conservación de este importante santuario natural y que de esta manera todos los actores que tienen incidencia sobre este territorio lleguen a acuerdos para su preservación, conservación y protección

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

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

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 9

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, volumen 9, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, que cuenta con el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. La gestión del conocimiento es un camino para consolidar una plataforma en las empresas públicas o privadas, entidades educativas, organizaciones no gubernamentales, ya sea generando políticas para todas las jerarquías o un modelo de gestión para la administración, donde es fundamental articular el conocimiento, los trabajadores, directivos, el espacio de trabajo, hacia la creación de ambientes propicios para el desarrollo integral de las instituciones

Resultados Semilleros de Investigación 2009-2010

La publicación recoge los doce informes finales de investigación presentados por los estudiantes de ocho Semilleros 1 y cuatro Semilleros 2, correspondientes a la convocatoria 2009–2010 y se constituye en el Número 25 de la Serie de Investigaciones en Construcción, si bien este es el primer Número publicado en formato digital que UNIJUS se permite poner a disposición no sólo de la comunidad universitaria, sino también de la sociedad colombiana e internacional, interesada en los temas estudiados por los jóvenes investigadores de la Facultad de Derecho, Ciencias Políticas y Sociales de la Universidad Nacional de Colombia

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Crecimiento de células madre de médula ósea del receptor, en el uréter donado de rata

Los trasplantes constituyen el principal tratamiento para algunas afecciones del sistema urinario, específicamente en los uréteres, estructuras pequeñas que cumplen la labor de transportar la orina desde los riñones a la vejiga, sin embargo los trasplantes tienen una alta tasa de rechazo, por lo que debe ser contrarrestado a partir del uso de inmunosupresores. Por lo cual se ha investigado desde la medicina regenerativa un elemento reconocido dentro de la anatomía humana por su cualidad de inmunorregulación, la médula ósea, que además es fuente tanto de células madre hematopoyéticas como mesenquimales; siendo estas características idóneas para ser usada como variante a la supresión del sistema inmunológico, durante la práctica de trasplantes. Las técnicas que utilizan células madre en terapia de reemplazo de órganos usualmente implican afectar el tejido para eliminar las células propias del donante. En esta investigación se plantea la posibilidad de implantar las células madre derivadas de la médula ósea directamente al órgano, generando un tipo de quimerismo (presencia de células de receptor y donante en el mismo tejido) que disminuyan las probabilidades de rechazo, gracias a su papel en la inmunorregulación. En este trabajo se demostró, por tinción con colorante DAPI, que el proceso de quimerización permite que las células madre extraídas de la médula ósea se adhieran y permanezcan en un uréter de rata. Los resultados son importantes dada la viabilidad del procedimiento y su impacto social al mejorar los resultados de los trasplantes.Pasantía de investigación (Ingeniero Biomédico)-- Universidad Autónoma de Occidente, 2018PregradoIngeniero(a) Biomédico(a

Multicriteria model applied to decision making representable in Ishikawa diagrams

La aplicabilidad de los diagramas de Ishikawa bajo el contexto de la toma de decisiones con criterios múltiples requiere de una metodología que guie al tomador de decisiones a lo largo de todo el proceso decisional. En este proyecto se propone un modelo multicriterio metodológico aplicado a la toma de decisiones representables en diagramas de Ishikawa, que valora las diferentes alternativas de solución planteadas a partir de las relaciones de causalidad identificadas en los diagramas de Ishikawa de forma adecuada y cuantificable.The applicability of Ishikawa diagrams under the context of decision making with multiple criteria requires a methodology to guide the decision maker throughout the decisional process. This project proposes a methodological multicriteria model applied to the decision making representable in Ishikawa diagrams, which assesses the different solution alternatives proposed from the causality relationships identified in the Ishikawa diagrams in an adequate and quantifiable way