Aprovechamiento de los sedimentos de los embalses como nutrientes para la fertilización de suelos agrícolas en la República Dominicana

Use of reservoir sediments as nutrients for the fertilization of agricultural soils in the Dominican Republic. The research project “Use of Reservoir Sediments as Nutrients for the Fertilization of Agricultural Soils in the Dominican Republic”, financed by FONDOCyT and in consortium with the University of Évora, Portugal. It addresses the problem of erosion in the hydrographic basins and sedimentation in the Sabana Yegua reservoirs located in the southern region of the Dominican Republic and Tavera in the northern region. The purpose of was to determine the nutritional quality of the sediments stored in the reservoirs, to use it as a soil improvement amendment in degraded areas of the basin, to ensure a greater water storage capacity in the reservoirs and improve its quality, with the purpose to guarantee the generation of hydroelectricity and supply the irrigation demand of agricultural producers. The method consisted of sampling the soils in the hydrographic basins, the sediments within the reservoirs, as well as in the water and determining the organic and inorganic elements and heavy metals. The results showed that the sediments of the reservoirs have a greater nutritional richness than the soils of the basins. The water Dominican Republic. The findings confirm the environmental benefits of using sediments as agricultural amendments. However, the economic analysis reveals that the use of these sediments as fertilizer makes it unprofitable for producers, due to the high costs of extraction, drying, transportation and application at the parcel level. It is recommended to carry out other studies in new agroclimatic zones and with other more profitable crops to evaluate profitability

Fundamentos de cirugía general : Esófago

Fundamentos de Cirugía General. Esófago, es una obra que nace de la pasión de autores nacionales e internacionales hacia un órgano frecuentemente olvidado con el único fin de proporcionar un acceso fácil y rápido al conocimiento actualizado. Este libro nos introduce en todo el proceso del conocimiento de la anatomía del esófago, así como sus principales afecciones y tratamiento. Un texto que logra exponer de manera breve lo esencial de la cirugía esofágica y pretende que el lector pueda relacionar desde la epidemiología y la fisiología de las enfermedades esofágicas hasta el abordaje clínico - quirúrgico donde los autores explican de forma sucinta y clara el tratamiento adecuado y actualizado. En síntesis, es una grandiosa obra realizada con la colaboración de reconocidos especialistas en los diferentes temas presentados, que trata cuidadosamente el diagnóstico y tratamiento de las múltiples enfermedades esofágicas, valiosas para la enseñanza y consulta permanente de los profesionales de la salud en todos sus campos

Estudo da relação entre as abordagens do Design Thinking e da Engenharia de Produção para o planejamento de projetos

Este trabalho trata inicialmente de um levantamento bibliográfico com base em artigos sobre aspectos do pensamento que compõem a formação em engenharia e a abordagem geralmente utilizada pela engenharia de produção para o planejamento de projetos. Em seguida,um levantamento bibliográfico com base em livros e artigos discute os principais conceitos relacionados à abordagem do Design Thinking, além de um dos principais métodos de aplicação desta abordagem, o método HCD. Finalmente, será realizado um estudo de caso para a análise da aplicação desta abordagem em um projeto real de serviços, de uma empresa de consultoria especializada em Design Thinking. Através da pesquisa conduzida é possível evidenciar as semelhanças e diferenças entre ambas as abordagens. Neste trabalho, as principais atividades observadas na aplicação do Design Thinking no estudo de caso de uma seguradora foram objeto de um estudo de similaridades com conteúdos de disciplinas do curso de graduação de engenharia de produção da UFRJ. A partir da análise destes dados, busca-se identificar possíveis complementariedades, quando o Design Thinking agrega algum valor às técnicas de engenharia de produção, ou inovações, quando traz atribuições sem precedentes nas disciplinas. Além disso,são feitas considerações para o futuro avanço e aplicação das técnicas. Espera-se que este trabalho possa ser usado por alunos e docentes que tenham interesse em conhecer referências de práticas e ferramentas de projetos voltados para a dimensão humana de problemas complexos. A apresentação e o estudo comparativo do conceito de Design Thinking com a abordagem da engenharia de produção pode ser de grande incentivo para inovação e criatividade de futuros engenheiros, servindo como ponto inicial para futuras pesquisas nesta área

Discurso pronunciado en la apertura del curso de 1851 a 52 en el Instituto de 2ª Enseñanza de Cuenca

Signaturizad

WASPSS: A Clinical Decision Support System for Antimicrobial Stewardship

The increase of infections caused by resistant bacteria has become one of the major health-care problems worldwide. The creation of multidisciplinary teams dedicated to the implementation of antimicrobial stewardship programmes (ASPs) is encouraged by all clinical institutions to cope with this problem. In this chapter, we describe the Wise Antimicrobial Stewardship Program Support System (WASPSS), a CDSS focused on providing support for ASP teams. WASPSS gathers the required information from other hospital systems in order to provide decision support in antimicrobial stewardship from both patient-centered and global perspectives. To achieve this, it combines business intelligence techniques with a rule-based inference engine to integrate the data and knowledge required in this scenario. The system provides functions such as alerts, recommendations, antimicrobial prescription support and global surveillance. Furthermore, it includes experimental modules for improving the adoption of clinical guidelines and applying prediction models related with antimicrobial resistance. All these functionalities are provided through a multi-user web interface, personalized for each role of the ASP team

Literature review: a surgeon’s view of recurrent hiatal hernia

Las hernias hiatales recidivantes constituyen una patología común que generan un reto diagnóstico y terapéutico para cirujanos y gastroenterólogos. Generalmente se presentan de forma asintomática o con síntomas atípicos y se asocian a factores fisiológicos, propios del paciente y de la técnica quirúrgica. Su tratamiento es complejo y dependiendo de la causa de los síntomas pueden requerir manejo médico o quirúrgico. En este artículo, se pretenden definir pautas para la identificación y manejo de esta patología, así como establecer claves para el tratamiento desde un enfoque quirúrgico.Recurrent hiatal hernias are a common pathology that generate a diagnostic and therapeutic challenge for surgeons and gastroenterologists. They are generally asymptomatic or present with atypical symptoms and are associated with the patient’s own physiological factors and the surgical technique. Treatment is complex and, depending on the cause of the symptoms, will require either medical or surgical management. This article starts from a surgical approach to define guidelines for identification and management of this condition and to establish keys to treatment

Neuroimaging studies of cognitive remediation in schizophrenia: A systematic and critical review

AIM: To examine the effects of cognitive remediation therapies on brain functioning through neuroimaging procedures in patients with schizophrenia. METHODS: A systematic, computerised literature search was conducted in the PubMed/Medline and PsychInfo databases. The search was performed through February 2016 without any restrictions on language or publication date. The search was performed using the following search terms: [('cogniti*' and 'remediation' or 'training' or 'enhancement') and ('fMRI' or 'MRI' or 'PET' or 'SPECT') and (schizophrenia or schiz*)]. The search was accompanied by a manual online search and a review of the references from each of the papers selected, and those papers fulfilling our inclusion criteria were also included. RESULTS: A total of 101 studies were found, but only 18 of them fulfilled the inclusion criteria. These studies indicated that cognitive remediation improves brain activation in neuroimaging studies. The most commonly reported changes were those that involved the prefrontal and thalamic regions. Those findings are in agreement with the hypofrontality hypothesis, which proposes that frontal hypoactivation is the underlying mechanism of cognitive impairments in schizophrenia. Nonetheless, great heterogeneity among the studies was found. They presented different hypotheses, different results and different findings. The results of more recent studies interpreted cognitive recovery within broader frameworks, namely, as amelioration of the efficiency of different networks. Furthermore, advances in neuroimaging methodologies, such as the use of whole-brain analysis, tractography, graph analysis, and other sophisticated methodologies of data processing, might be conditioning the interpretation of results and generating new theoretical frameworks. Additionally, structural changes were described in both the grey and white matter, suggesting a neuroprotective effect of cognitive remediation. Cognitive, functional and structural improvements tended to be positively correlated

Comparison of non-criteria antiphospholipid syndrome with definite antiphospholipid syndrome: A systematic review

Objectives: Patients with laboratory or clinical manifestations suggestive of antiphospholipid syndrome (APS) but not fulfilling the classification criteria constitute a clinical challenge. This study aims to compare non-criteria APS (NC-APS) with definite APS in terms of clinical manifestations, therapies, and outcomes. Methods: A systematic review of observational studies comparing definite and NC-APS was performed searching four electronic databases. Data on clinical manifestations, therapies and clinical outcomes was extracted. Results: Sixteen studies, assessing a total of 3,798 participants, were included. Seven out of 10 studies found no significant difference in the prevalence of arterial or venous thrombosis between definite and NC-APS, with two studies on seronegative APS also finding no difference in thrombosis recurrence. Seven out of 12 studies found no significant difference in the prevalence of obstetric manifestations between groups, with the remaining exhibiting conflicting results. In 9 studies comparing treatment frequency in obstetric patients, all but one described similar treatment frequency, with the percentage of NC-APS treated during pregnancy ranging from 26% to 100%. In 10 studies comparing pregnancy outcomes of NC-APS versus definite APS, 7 found similar successful pregnancies/live births. Additionally, 5 studies described improvement of live births in both groups with treatment, with three signalling aspirin monotherapy as efficacious as combination therapy in NC-APS. Conclusion: This review hints at an absence of marked differences in most evaluated parameters between definite and NC-APS, emphasizing the value of a more active follow-up of these patients. The low-quality available evidence highlights the need for well-defined NC-APS populations in future studies

Sexual onset and contraceptive use among adolescents from poor neighbourhoods in Managua, Nicaragua

Background and objectives: The prevalence of teenage pregnancies in Nicaragua is the highest in Latin-America. This study aimed to gain insight into factors which determine the sexual behaviours concerned. Methods: From July until August 2011, a door-to-door survey was conducted among adolescents living in randomly selected poor neighbourhoods of Managua. Logistic regression was used to analyse factors related to sexual onset and contraceptive use. Results: Data from 2803 adolescents were analysed. Of the 475 and 299 sexually active boys and girls, 43% and 54%, respectively, reported contraceptive use. Sexual onset was positively related to increasing age, male sex, alcohol consumption and not living with the parents. Catholic boys and boys never feeling peer pressure to have sexual intercourse were more likely to report consistent condom use. Having a partner and feeling comfortable talking about sexuality with the partner were associated with hormonal contraception. Conclusions: Our data identifi ed associates of adolescents ’sexual behaviour related to personal characteristics (sex and alcohol use), to the interaction with signifi cant others (parents, partners, peers) and to the environment (housing condition, religion). We interpreted those associates within the context of the rapidly changing society and the recently implemented health system reform in Nicaragua