Impuesto a las aguas saborizadas (refrescos): una alternativa para financiar el combate a la diabetes en México

Diabetes is the number one cause of death in people of productiveage in México, generating high economic and social costs at themicro and macroeconomic levels. In 90% of diabetes cases, theyare attributed to obesity, which is directly related to imbalancesin the diet and to a sedentary lifestyle. The average expenditurein soda consumption is equivalent to 12 and 7.5% of the basicfood basket, rural and urban, respectively. The objective ofthis study was to propose an alternative for financing diabetestreatment by imposing a tax on soda consumption. Themethodology consists in estimating the expenditure in diabetestreatment and soda consumption using information from theENSANUT 2006 databases, and performing a sensibility analysiswith different tax sums, and in view of different scenarios forproduct price elasticities. Results indicate that the incomegenerated from a tax of two to three pesos per liter, taking intoaccount a price elasticity between -0.5 and 1.0, might coverthe total cost generated by diabetes treatment in México, anddecrease its consumption in 13% to 19%.La diabetes es la primera causa de muerte en personas en edadproductiva en México, lo que genera elevados costos económicos ysociales a niveles micro y macroeconómicos. El 90% de los casos dediabetes se atribuyen a la obesidad, que se relaciona directamentecon desequilibrios en la dieta y sedentarismo. El gasto promedioen consumo de refresco equivale a 12 y 7.5% de la canasta básicaalimentaria rural y urbana respectivamente. El objetivo de estetrabajo fue proponer una alternativa para financiar el tratamientode diabetes imponiendo un impuesto al consumo de aguas saborizadas.La metodología consiste en estimar el gasto en el tratamientode diabetes y consumo de refresco a partir de las bases de datos dela ENSANUT 2006, y realizar un análisis de sensibilidad con distintosmontos de impuesto y ante distintos escenarios de elasticidadesprecio de los productos. Los resultados indican que el ingreso generadoa partir de un impuesto de entre dos y tres pesos por litro,contemplando una elasticidad precio entre -0.5 y 1.0, permitiríacubrir el gasto total generado por el tratamiento de diabetes enMéxico, y disminuir entre 13% y 19% su consumo

El papel del empleo rural no agrícola en las comunidades rurales: un estudio de caso en Tepeji del río, Hidalgo, México

Rural families are being increasingly incorporated to activitiesdifferent to the agricultural ones, since these activities representan important support to compensate the low agricultural incomes.On the other hand, the tighter interrelation between thecountryside and the city facilitates the participation in theemployment market and in the formal and informal commerce,widening the development capacities of the rural economies, andcausing a decrease on the relative importance of the agriculturalincome within the total rural income. The rural income is nolonger equivalent to the agricultural income in the Mexicancountryside. In this essay we analyze the role of the nonagricultural rural employment (NARE) through the resultsobtained by means of interviews and the application of a surveyto 70 families of the communities of Sta. María Magdalena andLa Cañada de Madero, both located in the municipality of Tepejidel Río de Ocampo in the state of Hidalgo, México. Also, thedifferent sources of non agricultural employment and the incomederiving from them, which represents more than 84% of the totalincome, are examined. lncome obtained through migration issignificative for some families; nevertheless, the remunerationscoming from local markets have the highest compensating impactof the low agricultural income. The households with better activesof human capital have higher capacity to assign their members todifferent markets; hence, the diversification of employments occursin the households with better demographic characteristics. Thechildren of common land owners benefit more than their parentsof non agricultural employments, since age and schooling levelare key factors to accede to better remunerated employmentsoutside agriculture.Las familias rurales se incorporan cada vez más a actividadesdistintas de la agricultura, porque representan un apoyo importantepara compensar los bajos ingresos agrícolas. Por otro lado,la mayor interrelación entre el campo y la ciudad facilita la participaciónen los mercados laboral y de comercio formal e informal,ampliando las capacidades de desarrollo de las economíasrurales, y causando una disminución en la importancia relativadel ingreso agrícola dentro del ingreso rural total. El ingresorural ya no equivale al ingreso agrícola en el campo mexicano.En este ensayo se analiza el papel del empleo rural no agrícola(ERNA) a través de los resultados obtenidos mediante entrevistasy la aplicación de una encuesta a 70 familias de las comunidadesde Sta. María Magdalena y la Cañada de Madero, ambas ubicadasen el municipio de Tepeji del Río de Ocampo en el estado deHidalgo, México. Se examinan las distintas fuentes de empleo noagrícola y el ingreso que de ellas se deriva, el cual representamás del 84% del ingreso total. El ingreso obtenido a través de lamigración es significativo para algunas familias; sin embargo, lasremuneraciones provenientes de los mercados locales tienen elmayor impacto compensador del bajo ingreso agrícola. Los hogarescon mejores activos de capital humano tienen mayor capacidadpara asignar a sus miembros a diferentes mercados, por loque la diversificación de empleos se presenta en los hogares conmejores características demográficas. Los hijos de los ejidatariosse benefician más que sus padres de los empleos no agrícolas,debido a que la edad y el nivel escolar son factores clave paraacceder a empleos mejor remunerados fuera de la agricultura

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher 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

Actualidad y prospectiva de la investigación científica en el Centro Universitario Amecameca de la Universidad Autónoma del Estado de México

Con responsabilidad, se organizó un programa cuya finalidad fuera publicitar con transparencia dichos avances, a través de un esfuerzo de rendición de cuentas a la comunidad inmediata, la universitaria, y a la comunidad abierta, la sociedad que la principal referencia para tal efecto. El programa se concretiza a través del presente libro, conformado con una inspiración de investigación multidisciplinaria; sin embargo, para llegar a tal fin, el reto es realizar el proceso de búsqueda y generación de conocimiento transitando hacia la colaboración de los cuerpos académicos, que puedan construir nuevos conocimientos fortalecidos por la convergencia de diferentes campos del saber. En consecuencia, la primera etapa de esta estrategia es la publicidad de los trabajos investigativos ejercidos, para hacer un balance al día, pero también proyectar el futuro de cada campo y área del conocimiento. La organización explicativa está organizada por tres bloques representativos del quehacer en la generación de conocimiento del Centro Universitario, un primer bloque centra el interés en las humanidades, educación y sustentabilidad; el segundo bloque lo integra la reflexión científica sobre la construcción democrática, derechos humanos y equidad de género; en el tercer segmento se destina a la seguridad alimentaria, salud pública y sistemas agropecuarios. La actualidad de la investigación eleva la producción lograda y lo que en el momento se encuentra en construcción y los alcances que produce para la docencia, la investigación misma, y para la sociedad en general. La prospectiva es un área que todos los capítulos desarrollan con el propósito de delinear los alcances innovadores por andar en teoría, metodología e incluso en los saberes mismo

ESTADO NUTRIMENTAL Y PRODUCCIÓN DE FRUTO DE MANGO (Mangifera indica L.), CV. TOMMY ATKINS, EN SUELOS LUVISOLES DEL ESTADO DE CAMPECHE, MÉXICO

Se estudió el estado nutrimental en árboles de mango ( Mangifera indica L.), en suelos Luvisoles del estado de Campeche, México, con fines de determinar posibles deficiencias y, en su caso, decidir acerca de la necesidad de realizar aplicaciones de fertilizantes. En huertos comerciales de mango se tomaron muestras de suelo, para determinar sus propiedades físicas y químicas, y de hoja, para especificar las concentraciones nutrimentales, a la vez que se obtuvo información sobre el manejo del huerto y del rendimiento de frutos. Se estimaron modelos de regresión del rendimiento como función de las concentraciones nutrimentales y propiedades físicas y químicas del suelo así como factores tecnológicos. Se establecieron los rangos de suficiencia nutrimental como expresión del estado nutrimental de los árboles. El rango de suficiencia ade - cuado fue, para N, de 0.90 a 1.35 %; P, de 0.07 a 0.11 %; K, de 0.5 a 0.8 %; Ca, de 3.5 a 3.75 %; Mg, de 0.16 a 0.25 %; Fe, de 75 ≥ 140 mg · kg -1 ; Mn, de 175 a 320 mg · kg -1 ; Cu, de 6 a 9 mg · kg -1 ; Zn, de 10 a 22 mg · kg -1 ; y, B de 85 a 210 mg · kg -1 . Con base en la distribución de los huertos en los rangos de suficiencia, se observó que hay huertos que requerirían aplicaciones de fertilizantes: P (48 %), K (52 %), Ca (62 %), Mg (56 %), Fe (73 %), Cu (65 %), y B (44 %). En cambio, las deficiencias son menores para Mn (17 %) y Zn (21 %), y no se observaron para N

Pensamiento Novohispano 20

El presente libro reúne 26 trabajos de investigación que tienen como objetivo mantener viva la relación cultural del presente con nuestro pasado histórico. Partimos del hecho de que somos seres históricos, es decir, pensamos y reconocemos la historia como parte constitutiva de nuestra existencia vital, razón que viene a consolidar el estudio y la investigación de nuestro pasado. El sentido que fortalece cada una de las colaboraciones aquí presentadas se convierte en un homenaje a la memoria histórica que recupera los hechos “pequeños”, los aparentemente “insignificantes”, para clarificar la “grandes” intervenciones. Cada uno de los trabajos aquí expuestos tiene el propósito de contribuir al estudio y difusión de la cultura novohispana.El número 20 de Pensamiento Novohispano ha quedado integrado por 26 trabajos de investigación distribuidos de la siguiente manera: 11 corresponden al siglo xvi; 5 al siglo XVII y 10 al siglo XVIII. Como en números anteriores, la diversidad de temas sigue presente, pues es una característica de este libro, que busca mantener viva la relación cultural de nuestro pasado histórico con el presente. Partimos del hecho de que somos seres históricos, es decir, pensamos y reconocemos la historia como parte constitutiva de nuestra existencia vital, razón que viene a consolidar el estudio y la investigación de nuestro pasado

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS

Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality

BACKGROUND AND PURPOSE: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. METHODS: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). RESULTS: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P CONCLUSIONS: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT