Evaluación de Algunas Propiedades de las Rocas encontradas en la Zona Central de la Vertiente Oriental de Medellín

The increasing and constant urban growth on the hillsides of the city of Medellín face large construction problems due to the presence of subsurface rock fragments. Such a fact motivates geotechnical engineers to characterize the materials present, soil or rock. This paperpresents some mechanical properties of the rocks found on the eastern hillsides of Aburra Valley which were measured on intact cylindrical rock cores and rock outcrops. The studied geological units are the San Diego Stock (KgD) and the Dunite of Medellín (KuM) and the measured rock properties are the uniaxial compressive strength, the static and dynamic module, the compressive shear wave velocity and the dynamic shear stiffness modulus.El creciente y constante crecimiento urbanístico sobre las laderas de la ciudad de Medellín enfrenta dificultades constructivas importantes debido a la presencia de fragmentos de roca en las diferentes unidades litológicas, tanto en superficie como en profundidad. Este hecho estimula que en algunas investigaciones geotécnicas de tipo académico se intente caracterizar los materiales presentes, ya sean suelo o roca. En este artículo se presentan algunas propiedades mecánicas relevantes de las rocas de la vertiente oriental del Valle de Aburra, evaluadas sobre núcleos cilíndricos de roca intacta y en afloramientos rocosos. Las unidades litológicas estudiadas son el Stock de San Diego (KgD) y la Dunita de Medellín (KuM) y las propiedades evaluadas fueron compresión uniaxial, módulos de elasticidad estático y dinámico, índice de rebote, velocidad de propagación de ondas compresivas y modulo dinámico de rigidez a cortante

Evaluación de Algunas Propiedades de las Rocas encontradas en la Zona Central de la Vertiente Oriental de Medellín

El creciente y constante crecimiento urbanístico sobre las laderas de la ciudad de Medellín enfrenta dificultades constructivas importantes debido a la presencia de fragmentos de roca en las diferentes unidades litológicas, tanto en superficie como en profundidad. Este hecho estimula que en algunas investigaciones geotécnicas de tipo académico se intente caracterizar los materiales presentes, ya sean suelo o roca. En este artículo se presentan algunas propiedades mecánicas relevantes de las rocas de la vertiente oriental del Valle de Aburra, evaluadas sobre núcleos cilíndricos de roca intacta y en afloramientos rocosos. Las unidades litológicas estudiadas son el Stock de San Diego (KgD) y la Dunita de Medellín (KuM) y las propiedades evaluadas fueron compresión uniaxial, módulos de elasticidad estático y dinámico, índice de rebote, velocidad de propagación de ondas compresivas y modulo dinámico de rigidez a cortante

The other special education : remembrance of a pedagogical journey

RESUMEN: La pregunta constante por las múltiples formas de relacionarse entre los seres humanos nos condujo a comprender que la educación y particularmente la educación especial —como nuestro espacio y discurso—, ha traído consigo un desconocimiento por el otro, que no se reduce al mundo exterior, la calle, la familia y la sociedad, sino que convierte también la escuela y sus prácticas en perpetuadoras de esto, revistiendo la educación de fines particulares, homogeneizantes y excluyentes, lo cual nos ha conducido por discursos donde la diversidad y la pluralidad aparecen como una discusión ambigua: teorías que ponen de manifiesto la otredad como una disertación humanista y desvictimizadora, o una realidad que nos confronta y cuestiona sobre eso que no queremos ser. Es, entonces, en medio de la pregunta por la educación, por los otros y nosotras mismas, por nuestras prácticas pedagógicas, que surgen reflexiones, historias, relaciones, sujetos y diferencias, a partir de la tesis de pregrado “Retos y perspectivas del encuentro entre educación indígena y educación especial: ¿narraciones interculturales?”, la cual nos convocó a pensar, contar y vivir este acontecimiento en el presente artículo, donde compartimos la experiencia educativa desde la conceptualización alrededor de la educación especial y el contacto con diferentes contextos educativos indígenas, lo que nos reveló posibles respuestas que significan y resignifican nuestra razón de ser como futuras maestras, viviendo, pensando y sintiendo una educación especial otra.ABSTRACT: The recurring question about the multiple forms of relationships among human beings led us to understand that education—particularly special education, as our realm and discourse—has brought about some forms of ignoring the others. This does not happen only in external environments, such as streets, the family and the society at large, but also inside the school and its practices, which perpetuate this situation, thus providing education with particular homogenizing and excluding ends, and leading to discourses in which diversity and plurality appear as part of an ambiguous discussion: As theories that introduce otherness as a humanistic and un-victimizing reasoning, or as a reality that confronts and questions us about what we don´t want to be. It is therefore amid the question for education, for the others and ourselves, and for our pedagogical practices, that reflections, histories, relationships, individuals, and differences sprung from the undergraduate dissertation “Challenges and perspectives of the encounter of indigenous education and special education: Intercultural narratives?” This work summoned us to think, tell, and live such event in this article, where we share our educative experience from the conceptualization about special education and the contact with different indigenous education contexts, which revealed to us possible responses that make ou

Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry

Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn's disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response

Immigrant IBD Patients in Spain Are Younger, Have More Extraintestinal Manifestations and Use More Biologics Than Native Patients

BackgroundPrevious studies comparing immigrant ethnic groups and native patients with IBD have yielded clinical and phenotypic differences. To date, no study has focused on the immigrant IBD population in Spain. MethodsProspective, observational, multicenter study comparing cohorts of IBD patients from ENEIDA-registry who were born outside Spain with a cohort of native patients. ResultsWe included 13,524 patients (1,864 immigrant and 11,660 native). The immigrants were younger (45 +/- 12 vs. 54 +/- 16 years, p < 0.001), had been diagnosed younger (31 +/- 12 vs. 36 +/- 15 years, p < 0.001), and had a shorter disease duration (14 +/- 7 vs. 18 +/- 8 years, p < 0.001) than native patients. Family history of IBD (9 vs. 14%, p < 0.001) and smoking (30 vs. 40%, p < 0.001) were more frequent among native patients. The most prevalent ethnic groups among immigrants were Caucasian (41.5%), followed by Latin American (30.8%), Arab (18.3%), and Asian (6.7%). Extraintestinal manifestations, mainly musculoskeletal affections, were more frequent in immigrants (19 vs. 11%, p < 0.001). Use of biologics, mainly anti-TNF, was greater in immigrants (36 vs. 29%, p < 0.001). The risk of having extraintestinal manifestations [OR: 2.23 (1.92-2.58, p < 0.001)] and using biologics [OR: 1.13 (1.0-1.26, p = 0.042)] was independently associated with immigrant status in the multivariate analyses. ConclusionsCompared with native-born patients, first-generation-immigrant IBD patients in Spain were younger at disease onset and showed an increased risk of having extraintestinal manifestations and using biologics. Our study suggests a featured phenotype of immigrant IBD patients in Spain, and constitutes a new landmark in the epidemiological characterization of immigrant IBD populations in Southern Europe

5to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

El V Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2019, realizado del 6 al 8 de febrero de 2019 y organizado por la Universidad Politécnica Salesiana, ofreció a la comunidad académica nacional e internacional una plataforma de comunicación unificada, dirigida a cubrir los problemas teóricos y prácticos de mayor impacto en la sociedad moderna desde la ingeniería. En esta edición, dedicada a los 25 años de vida de la UPS, los ejes temáticos estuvieron relacionados con la aplicación de la ciencia, el desarrollo tecnológico y la innovación en cinco pilares fundamentales de nuestra sociedad: la industria, la movilidad, la sostenibilidad ambiental, la información y las telecomunicaciones. El comité científico estuvo conformado formado por 48 investigadores procedentes de diez países: España, Reino Unido, Italia, Bélgica, México, Venezuela, Colombia, Brasil, Estados Unidos y Ecuador. Fueron recibidas un centenar de contribuciones, de las cuales 39 fueron aprobadas en forma de ponencias y 15 en formato poster. Estas contribuciones fueron presentadas de forma oral ante toda la comunidad académica que se dio cita en el Congreso, quienes desde el aula magna, el auditorio y la sala de usos múltiples de la Universidad Politécnica Salesiana, cumplieron respetuosamente la responsabilidad de representar a toda la sociedad en la revisión, aceptación y validación del conocimiento nuevo que fue presentado en cada exposición por los investigadores. Paralelo a las sesiones técnicas, el Congreso contó con espacios de presentación de posters científicos y cinco workshops en temáticas de vanguardia que cautivaron la atención de nuestros docentes y estudiantes. También en el marco del evento se impartieron un total de ocho conferencias magistrales en temas tan actuales como la gestión del conocimiento en la universidad-ecosistema, los retos y oportunidades de la industria 4.0, los avances de la investigación básica y aplicada en mecatrónica para el estudio de robots de nueva generación, la optimización en ingeniería con técnicas multi-objetivo, el desarrollo de las redes avanzadas en Latinoamérica y los mundos, la contaminación del aire debido al tránsito vehicular, el radón y los riesgos que representa este gas radiactivo para la salud humana, entre otros

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60&nbsp;years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death.&nbsp;The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death