Shared risk factors for COVID-19 and preeclampsia in the first trimester: An observational study

Coronavirus disease 2019; First trimester; PreeclampsiaCoronavirus 2019; Primer trimestre; PreeclàmpsiaCoronavirus 2019; Primer trimestre; PreeclampsiaIntroduction: The association between preeclampsia and coronavirus disease 2019 (COVID-19) is under study. Previous publications have hypothesized the existence of shared risk factors for both conditions or a deficient trophoblastic invasion as possible explanations for this association. The primary aim of this study was to examine baseline risk factors measured in the first-trimester combined screening for preeclampsia in pregnant women with COVID-19 compared with the general population. A secondary aim of this study was to compare risk factors among patients with mild and severe COVID-19. Material and methods: This was an observational retrospective study conducted at Vall d'Hebron Hospital Campus (Catalonia, Spain). Study patients were 231 pregnant women undergoing the first-trimester screening for preeclampsia and positive for severe acute respiratory syndrome coronavirus 2 between February 2020 and September 2021. The reference cohort were 13 033 women of the general population from six centers across Catalonia from May 2019 to June 2021. Based on the need for hospitalization, patients were classified in two groups: mild and severe COVID-19. First-trimester screening for preeclampsia included maternal history, mean arterial blood pressure, mean uterine artery pulsatility index (UtAPI), placental growth factor (PlGF), and pregnancy-associated plasma protein-A (PAPP-A). Results: The proportion of cases at high risk for preeclampsia was significantly higher among the COVID-19 group compared with the general population (19.0% and 13.2%, respectively; p = 0.012). When analyzing risk factors for preeclampsia individually, women with COVID-19 had higher median body mass index (25.2 vs 24.5, p = 0.041), higher UtAPI multiple of the median (MoM) (1.08 vs 1.00, p < 0.001), higher incidence of chronic hypertension (2.8% vs 0.9%, p = 0.015), and there were fewer smokers (5.7% vs 11.6%, p = 0.007). The MoMs of PlGF and PAPP-A did not differ significantly between both groups (0.96 vs 0.97, p = 0.760 and 1.00 vs 1.01, p = 0.432; respectively). Conclusions: In patients with COVID-19, there was a higher proportion of women at high risk for preeclampsia at the first-trimester screening than in the general population, mainly because of maternal risk factors, rather than placental signs of a deficient trophoblastic invasion

Workaholism and work-family interaction among emergency and critical care nurses

Objectives: Investigating the prevalence of workaholism as well as the relationship between work-family interaction among emergency and critical care nurses. Research methodology/design: A quantitative cross-sectional study. Setting: A total of 219 nurses took part in the Dutch Work Addiction Scale (DUWAS-10) and the Survey WorkHome Interaction Nijmegen (SWING), which included socio–demographic and occupational question. Data was gathered in Spain between June and September 2019. Results: Workaholism was found to be prevalent in 28.3% of the participants. In all four categories, workaholism was statistically connected to work-home interaction, with workaholics having higher means than nonworkaholics. Perceived work stress was related to workaholism (p =.036). In the Work Excessively dimension, female nurses had significantly higher mean scores (M = 2.26) than their male counterparts (M = 1,88). In addition, in the Negative Work-Home Interaction (M = 2.04), the global mean scores were higher than in the Negative Home-Work Interaction (M = 1.34), indicating conflict and a negative impact of work on the family. Conclusion: The findings of this study demonstrated the necessity of taking into account demands and resources from both the work and home domains since it has been shown that both have an impact on one other. Furthermore, given the vital responsibilities that emergency and critical care nurses play in the health care system, our findings suggest that occupational health treatments should be used to identify those working profiles that are particularly at risk.info:eu-repo/semantics/publishedVersio

Propuesta de mejora en las áreas de producción y logística mediante las metodologías MRP, Lean Manufacturing, estudio de tiempos y ecoindicadores para aumentar la rentabilidad en la Corporación Minera F&E SAC

El presente trabajo tuvo como objetivo general el diseño de una propuesta de mejora en las áreas de producción y logística para incrementar la rentabilidad de la empresa Corporación Minera F&E S.A.C. Mediante un diagnóstico realizado a la empresa se pudo identificar cuáles eran los problemas más importantes en las áreas de producción (falta de estandarización de materia prima, falta de capacidad de las máquinas clasificadora y zaranda, falta de capacitación al personal, inadecuada limpieza y orden de las áreas y tiempos de trabajo no estandarizados ni escritos) y logística (no existe un control del stock de materia prima, falta de un análisis del impacto ambiental, falta de un área para almacenamiento correctamente estructurada y falta de un procedimiento para la selección de proveedores de transporte) , luego aplicamos las metodologías, herramientas y técnicas más apropiadas para un resultado eficiente y satisfactorio como Control Estadístico, MRP, Gestión del personal, Lean Manufacturing, Medición del trabajo, Ecoindicadores, Método de selección multicriterio). Finalmente, obtuvimos como resultado de este trabajo se pudo crear un ahorro del S/. 495 162.6 en el área de producción S/. 803 679.12 en el área de logística, además de un VAN de S/. 2 813 990, un TIR del 124% y un beneficio-costo de 6.18, además de incrementar la rentabilidad sobre las ventas de un 21.53% a un 26.6%, lo cual demuestra que la implementación de nuestra mejora sería beneficiosa para la empresa.The main objective of this work was to design a proposal for improvement in the areas of production and logistics to increase the profitability of the Mining Company F&E S.A.C. Through a diagnosis made to the company it was possible to identify which were the most important problems in the areas of production (lack of standardization of raw material, lack of capacity of sorting and sifting machines, lack of personnel training, inadequate cleaning and order of areas and work times not standardized or written) and logistics (there is no control of the raw material stock, lack of an environmental impact analysis, lack of a properly structured storage area and lack of a procedure for the selection of transport providers) then we applied the most appropriate methodologies, tools and techniques for an efficient and satisfactory result. Finally, we obtained as a result of this work we were able to create a savings of S /. 495 162.6 in the production area S /. 803 679.12 in the logistics area, in addition to a VAN of S /. 2 813 990, an IRR of 124% and a benefit-cost of 6.18, in addition to increasing the return on sales from 21.53% to 26.6%, which shows that the implementation of our improvement would be beneficial for the company

Bovine Tuberculosis Testing in Colombia: Comparative Histopathological, Microbiological, and Molecular Biology Findings

Introduction: Bovine tuberculosis (bTB) is a zoonotic infectious disease present in Colombia, caused by Mycobacterium bovis, and causes tuberculosis in water buffalo (Bubalus bubalis). Diagnosis of bovine tuberculosis through the intradermal test is difficult; evaluating and understanding the behavior of other diagnostic tests is necessary. Objective: To describe the behavior and results of different diagnostic methods for bovine tuberculosis in water buffalo positive for the Purifed Proteic Derivate (DPP) intradermal test. Methodology: In water buffaloes positive for comparative cervical tuberculin test, different diagnostic methods were applied, described, and compared: Ziehl-Neelsen staining, microbiological culture, histopathological analysis, and PCR-HRM. Results: Histopathological tests showed that 26 water buffalo positive for DPP (52%) had histological lesions compatible with bovine tuberculosis. 37% of the evaluated samples from tuberculin-positive Buffalo's lungs and secondary lymph nodes showed acid-alcohol-resistant bacillus with Ziehl-Neelsen staining. Four samples of Mycobacterium bovis from tuberculin-positive buffalo were isolated and identified, with two of these isolates confirmed from tissues with PCR-HRM, and three buffalo with microbiological isolates presented granulomatous lesions through histological analysis. Seventeen tuberculin-positive buffalo (34%) tested positive for real-time PCR HRM, and nine of these buffalo did not have histological lesions compatible with bTB and were confirmed with the molecular test. Conclusion: Our results provide positive evidence of histological findings, microbiological isolation, and molecular diagnosis of tuberculin-positive water buffalo in the lowlands of Colombia. None of the complementary tests performed showed 100% concordance with the comparative cervical tuberculin test results for bTB

Confirmation of preeclampsia-like syndrome induced by severe COVID-19 : An Observational Study

Since the outbreak of the COVID-19 pandemic, some studies have reported an increased preeclampsia (PE) incidence in pregnant women with SARS-CoV-2 infection. Several explanations for this association have been proposed, including a preeclampsia-like syndrome induced by severe COVID-19. This syndrome was described in a small case series and has not been confirmed in larger studies and its impact in perinatal outcomes has not been studied. The aim of this study was to confirm the preeclampsia-like syndrome due to COVID-19 and to investigate its implications in pregnancy outcomes and prognosis. This was a prospective, observational study conducted in a tertiary referral hospital. Inclusion criteria were pregnant women admitted to the Intensive Care Unit for severe pneumonia due to COVID-19. They were classified in three groups based on clinical and laboratory findings: PE, PE-like syndrome, and women without PE features. The three cohorts were analyzed and compared at three different times: before, during and after severe pneumonia. The main outcomes were incidence of adverse perinatal outcomes and signs and symptoms of PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes and increased angiogenic factors (soluble fms-like tyrosine kinase-1 to placental growth factor ratio [sFlt-1/PlGF]). A total of 106 women were admitted to Intensive Care Unit due to severe pneumonia and 68 were included in the study. Of those, 53 (50.0%) did not meet the diagnostic criteria for PE and remained pregnant after pneumonia (non-PE), seven (6.6%) met the diagnostic criteria for PE, had abnormal (>38) sFlt-1/PlGF (PE) and delivered during severe pneumonia, and eight (7.5%) met the diagnostic criteria for PE, had normal (≤38) sFlt-1/PlGF (PE-like) and did not deliver during pneumonia. Despite not having delivered, most PE-related features improved after severe pneumonia in women with PE-like syndrome. Women with PE had significantly poorer outcomes than women with PE-like syndrome or without PE. More than 50% of women with severe COVID-19 and diagnostic criteria for PE may not be PE but a PE-like syndrome, which may affect up to 7.5% of women with severe COVID-19. PE-like syndrome might have similar perinatal outcomes to those of normotensive women with severe pneumonia due to COVID-19. For these reasons, PE-like syndrome should be excluded by using sFlt-1/PlGF in future research and before making clinical decisions

Clinical and economic impact of current ALK rearrangement testing in Spain compared with a hypothetical no-testing scenario

Background: Currently biomarkers play an essential role in diagnosis, treatment, and management of cancer. In non-small cell lung cancer (NSCLC) determination of biomarkers such as ALK, EGFR, ROS1 or PD-L1 is mandatory for an adequate treatment decision. The aim of this study is to determine the clinical and economic impact of current anaplastic lymphoma kinase testing scenario in Spain. Methods: A joint model, composed by decision-tree and Markov models, was developed to estimate the long-term health outcomes and costs of NSCLC patients, by comparing the current testing scenario for ALK in Spain vs a hypothetical no-testing. The current distribution of testing strategies for ALK determination and their sensitivity and specificity data were obtained from the literature. Treatment allocation based on the molecular testing result were defined by a panel of Spanish experts. To assess long-term effects of each treatment, 3-states Markov models were developed, where progression-free survival and overall survival curves were extrapolated using exponential models. Medical direct costs (expressed in €, 2019) were included. A lifetime horizon was used and a discount rate of 3% was applied for both costs and health effects. Several sensitivity analyses, both deterministic and probabilistic, were performed in order test the robustness of the analysis. Results: We estimated a target population of 7628 NSCLC patients, including those with non-squamous histology and those with squamous carcinomas who were never smokers. Over the lifetime horizon, the current ALK testing scenario produced additional 5060 and 3906 life-years and quality-adjusted life-years (QALY), respectively, compared with the no-testing scenario. Total direct costs were increased up to € 51,319,053 for testing scenario. The incremental cost-effectiveness ratio was 10,142 €/QALY. The sensitivity analyses carried out confirmed the robustness of the base-case results, being the treatment allocation and the test accuracy (sensitivity and specificity data) the key drivers of the model. Conclusions: ALK testing in advanced NSCLC patients, non-squamous and never-smoker squamous, provides more than 3000 QALYs in Spain over a lifetime horizon. Comparing this gain in health outcomes with the incremental costs, the resulting incremental cost-effectiveness ratio reinforces that testing non-squamous and never-smoker squamous NSCLC is a cost-effective strategy in Spain

Implementación de un modelo de validación para la definición y mantenimiento de procesos de desarrollo de software

Las empresas de desarrollo de software, en búsqueda de mejorar su rendimiento y la calidad de sus productos, implementan modelos y normas como CMMI e ISO. Para sostener la mejora en el tiempo, es necesario modificar los procesos continuamente para adaptarlos al contexto cambiante. Los cambios en el proceso pueden incurrir en el incumplimiento de una norma o modelo en los que el proceso fue basado. Por ello es importante crear, mantener y evaluar mapeos entre el proceso y los modelos. Estos mapeos son útiles al momento de la validación de los procesos respecto de los modelos. Una dificultad que se presenta al momento de la validación es que los requerimientos de los modelos están descriptos en lenguaje natural quedando librados a la interpretación de un experto. Este trabajo presenta un metamodelo que permite definir en forma más precisa los requerimientos de los modelos y las normas y un mecanismo de mapeo y validación de procesos.Sociedad Argentina de Informática e Investigación Operativ

Confirmation of preeclampsia-like syndrome induced by severe COVID-19: an observational study

COVID-19; Preeclampsia; PregnancyCOVID-19; Preeclampsia; EmbarazoCOVID-19; Preeclampsia; EmbaràsBACKGROUND Since the outbreak of the COVID-19 pandemic, some studies have reported an increased preeclampsia incidence in pregnant women with SARS-CoV-2 infection. Several explanations for this association have been proposed, including a preeclampsia-like syndrome induced by severe COVID-19. This syndrome was described in a small case series and has not been confirmed in larger studies, and its effect on perinatal outcomes has not been studied. OBJECTIVE This study aimed to confirm the preeclampsia-like syndrome because of COVID-19 and to investigate its implications on pregnancy outcomes and prognosis. STUDY DESIGN This was a prospective, observational study conducted in a tertiary referral hospital. The inclusion criteria were pregnant women admitted to the intensive care unit for severe pneumonia because of COVID-19. They were classified into 3 groups based on clinical and laboratory findings: preeclampsia, preeclampsia-like syndrome, and women without preeclampsia features. The 3 cohorts were analyzed and compared at 3 different times: before, during, and after severe pneumonia. The main outcomes were incidence of adverse perinatal outcomes and signs and symptoms of PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, and increased angiogenic factors (soluble fms-like tyrosine kinase 1–to–placental growth factor ratio). RESULTS A total of 106 women were admitted to the intensive care unit because of severe pneumonia, and 68 women were included in the study. Of those, 53 (50.0%) did not meet the diagnostic criteria for preeclampsia and remained pregnant after pneumonia (non-preeclampsia); 7 (6.6%) met the diagnostic criteria for preeclampsia, had abnormal (>38) soluble fms-like tyrosine kinase 1–to–placental growth factor ratio (preeclampsia), and delivered during severe pneumonia, and 8 (7.5%) met the diagnostic criteria for preeclampsia, had normal (≤38) soluble fms-like tyrosine kinase 1–to–placental growth factor ratio (preeclampsia like), and did not deliver during pneumonia. Despite not having delivered, most preeclampsia-related features improved after severe pneumonia in women with preeclampsia-like syndrome. Women with preeclampsia had significantly poorer outcomes than women with preeclampsia-like syndrome or without preeclampsia. CONCLUSION More than 50% of women with severe COVID-19 and diagnostic criteria for preeclampsia may not be preeclampsia but a preeclampsia-like syndrome, which may affect up to 7.5% of women with severe COVID-19. Preeclampsia-like syndrome might have similar perinatal outcomes to those of normotensive women with severe pneumonia because of COVID-19. For these reasons, preeclampsia-like syndrome should be excluded by using soluble fms-like tyrosine kinase 1–to–placental growth factor ratio in future research and before making clinical decisions

Propuesta estratégica de mejora en la implementación de los estándares mínimos del Sistema de la Seguridad y Salud en el Trabajo (SG-SST) en la Empresa CONSTRUMAS para el año 2020.

El presente trabajo tiene como finalidad dar a conocer la importancia de la Gerencia del Talento Humano e integrar los diferentes conceptos y temáticas relacionados para la elaboración de estrategias en donde se permita potenciar las organizaciones a través del desarrollo y retención del talento humano que las componen acordes con las necesidades de la organización y que contribuyen a la consecución de los objetivos organizacionalesThe purpose of this work is to publicize the importance of the Management of Human Talent and integrate the different concepts and related themes for the elaboration of strategies in which organizations are allowed to enhance through the development and retention of human talent that compose them according to the needs of the organization and that contribute to the achievement of organizational objective

Structure and Function of a Mycobacterial NHEJ DNA Repair Polymerase

Non homologous end-joining (NHEJ)-mediated repair of DNA double-strand breaks in prokaryotes requires Ku and a specific multidomain DNA ligase (LigD). We present crystal structures of the primase/polymerisation domain (PolDom) of Mycobacterium tuberculosis LigD, alone and complexed with nucleotides. The PolDom structure combines the general fold of the archaeo-eukaryotic primase (AEP) superfamily with additional loops and domains that together form a deep cleft on the surface, likely used for DNA binding. Enzymatic analysis indicates that the PolDom of LigD, even in the absence of accessory domains and Ku proteins, has the potential to recognise DNA end-joining intermediates. Strikingly, one of the main signals for the specific and efficient binding of PolDom to DNA is the presence of a 5'-phosphate group, located at the single/double-stranded junction at both gapped and 3'-protruding DNA molecules. Although structurally unrelated, Pol lambda and Pol mu, the two eukaryotic DNA polymerases involved in NHEJ, are endowed with a similar capacity to bind a 5'-phosphate group. Other properties that are beneficial for NHEJ, such as the ability to generate template distortions and realignments of the primer, displayed by Pol lambda and Pol mu, are shared by the PolDom of bacterial LigD. In addition, PolDom can perform non-mutagenic translesion synthesis on termini containing modified bases. Significantly, ribonucleotide insertion appears to be a recurrent theme associated with NHEJ, maximised in this case by the deployment of a dedicated primase, although its in vivo relevance is unknown