Formal [3+2] Cycloaddition Reactions of Electron-Rich Aryl Epoxides with Alkenes under Lewis Acid Catalysis Affording Tetrasubstituted Tetrahydrofurans

We report on the regio- and stereoselective synthesis of tetrahydrofurans by reaction between epoxides and alkenes in the presence of a Lewis acid. This is an unprecedented formal [3+2] cycloaddition reaction between an epoxide and an alkene. The chemical reaction represents a very concise synthesis of tetrahydrofurans from accessible starting compounds

An Efficiency Improvement Approach to Reduce Transportation Costs: An Application

The reduction of transportation costs is an important issue for many companies that need to stay competitive. This work describes the application of a scheme for increasing transportation efficiency to achieve this purpose. This scheme is developed around a modified version of the Operational Equipment Effectiveness index used in TPM. This is adapted to be used as the main performance measure in transport operations. Availability, performance and quality wastes are identified using Value Stream Mapping of the operation. The implementation is carried out in the routing operation of a Mexican firm. The improvement initiatives are still in progress but the projected and available results are provided

Propuesta de plan de metas para la búsqueda de un portafolio de influenciadores más comercial

En el trabajo presentado a continuación se abarca como tema principal la correcta implementación de incentivos para motivar a los influenciadores de una empresa que se dedica a realizar campañas de mercadeo digital. Más específicamente queremos mostrar que es vital para la compañía en cuestión, motivar a su talento humano porque su objeto social está directamente logado a él, y que esto le generará una mejora directa en los ingresos. A través de este trabajo se quiere proponer el plan de incentivos más adecuado para logarlo.In this work, the main topic is the correct implementation of incentives to motivate the influencers of a company that is dedicated to developing digital marketing campaigns. More specifically, we want to show that it is vital for the company to motivate its human talent because its social purpose is directly aimed at it, and that this will generate a direct improvement in revenues. Through this work we want to propose the most suitable incentive plan to achieve it.Administrador (a) de EmpresasPregrad

Outcome of patients with autoimmune diseases in the intensive care unit. A mixed cluster analysis.

Antecedentes: El interés en las enfermedades autoinmunes (EA) y su desenlace en la unidad de cuidado intensivo (UCI) han incrementado debido al reto clínico que suponen para el diagnóstico y manejo, debido a que la mortalidad en UCI fluctúa entre el 17 – 55 %. El siguiente trabajo representa la experiencia de un año de nuestro grupo en un hospital de tercer nivel. Objetivo: Identificar factores asociados a mortalidad particulares de los pacientes con enfermedades autoinmunes que ingresan a una UCI, de un hospital de tercer nivel en Bogotá, Colombia. Métodos: El uso de análisis de componentes principales basado en el método descriptivo multivariado y análisis de múltiple correspondencia fue realizado para agrupar varias variables relacionadas con asociación significativa y contexto clínico común. Resultados: Cincuenta pacientes adultos con EA con una edad promedio de 46,7 ± 17,55 años fueron evaluados. Los dos diagnósticos más comunes fueron lupus eritematoso sistémico y esclerosis sistémica, con una frecuencia de 45% y 20% de los pacientes respectivamente. La principal causa de admisión en la UCI fue la infección seguido de actividad aguda de la EA, 36% y 24% respectivamente. La mortalidad durante la estancia en UCI fue del 24%. El tiempo de hospitalización antes de la admisión a la UCI, el choque, soporte vasopresor, ventilación mecánica, sepsis abdominal, Glasgow bajo y plasmaféresis fueron factores asociados con mortalidad. Dos fenotipos de variables fueron definidos relacionadas con tiempo en la UCI y medidas de soporte en UCI, las cuales fueron asociadas supervivencia y mortalidad. Conclusiones: La identificación de factores individuales y grupos de factores por medio del análisis de componentes principales permitirá la implementación de medidas terapéutica de manera temprana y agresiva en pacientes con EA en la UCI para evitar desenlaces fatales.Objective: The interest on autoimmune diseases (ADs) and their outcome at the intensive care unit (ICU) has increased due to the clinical challenge for diagnosis and management, due to mortality that range between 17- 55%. The current work presents a-year experience on factors related with mortality of patients with Ads in a tertiary hospital. Methods: The mixed-cluster methodology based on multivariate descriptive methods such as principal component analysis and multiple correspondence analyses was performed to summarize sets of related variables with strong associations and common clinical context. Results: Fifty adult patients with ADs with a mean age of 46.7 ± 17.55 years were assessed. The two most common diagnoses were systemic lupus erythematosus and systemic sclerosis, registered in 45% and 20% of patients, respectively. The main causes of admission to ICU were infection and AD flare up, observed in 36% and 24%, respectively. Mortality during ICU stay was 24%. The length of hospital stay before ICU admission, shock, vasopressors, mechanical ventilation, abdominal sepsis, Glasgow score and plasmapheresis were all factors associated with mortality. Two new clinical clusters variables (NCVs) were defined: Time ICU and ICU Support Profile, which were associated with survivor and no survivor variables. Conclusion: There is still a high morbidity and mortality in patients with ADs seen at the ICU. Identification of single factors and groups of factors from NCVs will allow implementation of early and aggressive therapies in patients with ADs at the ICU in order to avoid fatal outcomes

Poblados y explotaciones mineras como fuentes de recursos del turismo rural: el Andévalo Occidental, Huelva (España)

Hasta hace poco hablar de turismo en la provincia de Huelva era hacerlo exclusivamente de los espacios litorales. Aún hoy, y por mucho tiempo, estas áreas seguirán acaparando la mayor parte de la demanda y de los equipamientos, basados en el binomio “sol y playa”. No obstante, en los últimos años los espacios del interior se van acercando a la nueva demanda turística, ofertando unos paisajes rurales, un medio ambiente y un patrimonio histórico-cultural diferente a os de las áreas turísticas litorales.Un poco más allá de esta temática, las áreas industriales y mineras, sumidas en la crisis del sistema productivo del mineral, encuentran hoy un nuevo camino para el desarrollo en la puesta en valor de su patrimonio minero-industrial. Una de estas áreas mineras es el Andévalo Occidental, donde la minería ha sido uno de los pilares sobre los que se ha cimentado tradicionalmente su economía, y que ha marcado su evolución a través de los siglos. El desarrollo de los municipios localizados en esta comarca ha estado fundamentado, esencialmente, en la explotación coyuntural de sus recursos naturales, casi exclusivamente de la minería metálica.Until recently, talk about tourism in the province of Huelva was to do exclusively with the coastal areas. Even today, and for a long time, these areas will continue hoarding the bulk of demand and equipment, based on the binomial “sun and sand”. However, in recent years the interior spaces are approaching the new demand for tourism, offering a rural landscape, an environment and a diffe- rent cultural and historical heritage to you coastal tourist areas. A little beyond this issue, industrial and mining areas, sunk into crisis ore production system, today found a new path for development in the value enhancement of industrial mining heritage. One such area is the Andévalo Western mining, where mining has been one of the pillars upon which traditionally has built its economy, which has marked its evolution through the centuries. The development of the municipalities located in this region has been based essentially on short-term exploitation of natural resources, almost exclusively from metal mining

Mindfulness y experiencias psicóticas en estudiantes universitarios

The study of the relation between psychotic experiences and mindfulness in the general population is linked to research into factors of risk and protection against the development of a psychotic disorder. This study looks into the presence of psychotic experiences in a sample of university students and whether there is any variation according to gender. It also analyzes the predictive and discriminant relation of mindfulness with these experiences. The sample consisted of 526 university students (72.8% women) with a mean age of 21.39 years (SD = 3.53). The results showed the presence of psychotic experiences with differing levels of intensity, with variations according to gender, and an inverse relationship between mindfulness and psychotic experiences. Results indicated that students with high scores in psychotic experiences had lower scores in mindfulness. Our findings imply that mindfulness may be a factor of protection against psychotic experiences and its training may have a role to play in the development and implementation of preventive and early intervention programs in risk groups in the general and clinical population.El estudio de la relación entre experiencias psicóticas y mindfulness en la población general se asocia con la investigación de factores de riesgo y protección frente al desarrollo de un trastorno psicótico. Con este estudio se pretende examinar la presencia de experiencias psicóticas en una muestra de estudiantes universitarios y sus diferencias según el sexo, así como analizar la relación predictiva y discriminante de mindfulness con estas experiencias. Los participantes fueron 526 estudiantes universitarios (72.8% mujeres) con una media de edad de 21.39 años (DT = 3.53). Los resultados mostraron la presencia de experiencias psicóticas con diferentes niveles de intensidad, diferencias según el sexo en las mismas, y una relación inversa entre mindfulness y las experiencias psicóticas, y se encontró que las personas con altas puntuaciones en experiencias psicóticas contaron con menores puntuaciones en mindfulness. Estos resultados suponen que mindfulness puede ser un factor de protección en la experimentación de experiencias psicóticas y su entrenamiento puede ser útil para implementación y desarrollo de programas preventivos y de intervención precoz en grupos de riesgo en población general y clínica

Acute and chronic bovine pulmonary edema and emphysema in Uruguay

An outbreak of pulmonary edema and emphysema with acute and chronic cases is reported in a farm in Uruguay. In a herd of 40 Hereford steers, 20 died. The deaths began four days after a change of paddock, from an old pasture of Avena sativa to a lush growing pasture of the same grass. Acutely affected animals showed severe dyspnea, sialorrhea, cough, and subcutaneous edema, and died within 72 hours. Chronically affected steers showed dyspnea, respiratory noises, weight loss, and intolerance to exercise. The deaths began four days after the change of paddock. Ten days after the first death, the steers were withdrawn from the pasture, but continued dying throughout the following 40 days. Twenty animals died and six were necropsied. Grossly, the lungs were diffusely armed and glistening, with reddish and crepitant cut surface, and presented alveolar septae sharply distended by edema and emphysema. There was subpleural emphysema with air blebs distributed across the pleural surface. Presence of Dictyocaulus viviparus was observed in three steers. In some animals, the trachea was diffusely reddish with presence of pink foam; in some others, there was bloody liquid in the tracheal lumen. Histologic examination showed severe diffuse alveolar and interstitial emphysema, hyaline membranes adhered to the alveolar wall, thickening of the interlobular septae with proliferation of type II pneumocytes, and moderate-to-severe multifocal histiocytic, neutrophilic and eosinophilic infiltrate. In the trachea, there was submucosal hemorrhage and moderate multifocal eosinophilic and lymphocytic infiltrate. The steers with chronic signs presented similar lung lesions, but multifocal pulmonary fibrosis and cardiac dilatation were also observed. The diagnosis of acute bovine pulmonary emphysema and edema (ABPE) was based on the occurrence of the disease after introduction of the herd in a lush green pasture, on the characteristic gross and histologic lesions, and on the absence of other toxic or infectious agents causing similar lesions. Cattle raisers should be alert to the risks of occurrence of this disease after the introduction of the herds into paddocks with green and lush pasture

Potential interactions in a cohort of elderly hiv-positive patients

Abstract: Objective: The increase of HIV-patients life expectancy leads to a new model of patient with chronic diseases and polymedicated. For this reason we ought to know in clinical practice the prevalence of polypharmacy and drug-drug interactions between the antiretroviral drugs and comedication in our patients in order to identify and prevent them. Method: A retrospective, descriptive study carried out in > 50 years old patients on antiretroviral treatment. Results: We included 242 patients of whom 148 (61%) were receiving concomitant treatment. 243 potential interactions were detected, where 197 are considered moderate and 46 severe, affecting 110 patients. 35 (76%) interactions were related to boosted protease inhibitors. The main consequence of these interactions was the increase in plasma concentrations of comedication (48%). Statins were the comedication most involved in severe drug-druginteractions (24%), followed by inhaled corticosteroids (15%). Conclusions: Polypharmacy was found in about half of our study population and the prevalence of drug-drug interactions was high. Hospital pharmacists may play a crucial role in their detection, management and early communication

Actitud frente a la Violencia de Género del alumnado de Enfermería y su relación con la formación universitaria recibida

El reconocimiento del papel crucial que la educación puede y debe desempeñar en la erradicación de la violencia contra la mujer es una idea consolidada entre las personas que trabajan específicamente en este tema desde distintos ámbitos1, que considera la educación como una herramienta fundamental para cambiar las actitudes y las conductas que llevan a perpetuar el sexismo y la violencia de género de generación en generación2. En concreto en el ámbito de Enfermería hay estudios3, 4 que analizan el posicionamiento de las enfermeras y enfermeros ante esta problemática y revelan un déficit en la formación recibida a nivel de currículo, y un desconocimiento a la hora de derivar estas situaciones sobre todo por entender que es un problema privado5. Además indican que la tasa autocomunicada de maltrato como causa de lesiones mejora cuando la mujer es preguntada por enfermeras y enfermeros sensibilizadas/os y formadas/os en la materia

Mexican World Heritage information on the web: Institutional presence and visibility

This study offers a global overview of the presence and visibility of web information on UNESCO World Heritage located in Mexico, via the analysis of official websites and Web 2.0 information. Cultural heritage is a determining factor in linking people to their history, and contributes to increasing cultural tourism and economic development. The study starts from the hypothesis that the design of these has an influence on the dissemination and popularity of the aforementioned heritage. The relationships between the administrative organization of the country and Internet protocols are compared. A webometric study of the official Mexican websites was carried out. An evaluation sheet was designed to allow the assessment of aspects relating to identification, presence, accessibility and content. The multilingual nature of this information and its presence on social networks and Wikipedia was analysed. The analysis of URLs confirms that the domain .mx is used in 84% of cases. The results indicate a noticeable use of Web 2.0 dissemination of the heritage assets on YouTube (51%) and Facebook (40%), followed by 23% on Twitter. The Web Accessibility Initiative (WAI) guidelines are not yet frequently applied. Finally, the results obtained make it possible to identify variables that can contribute to improvements in the visibility and dissemination of official web information.This paper was supported by the RD & I Project, HAR2012-38562 (Spanish Ministry of Economy and Competitiveness)