La estructura productiva de Nicaragua: retos y posibilidades

El articulo explica en forma sucinta "la estructura productiva de Nicaragua, con sus éxitos, sus problemas y sus posibilidades

La estructura productiva de Nicaragua: retos y posibilidades

Recién terminada mi “Estructura Económica de Nicaragua y su contexto centroamericano y mundial” (en prensa), que me ha ocupado por más de dos años la recopilación de información y su análisis, me atrevo a resumir en pocas páginas los grandes ejes que configuran la estructura productiva de Nicaragua, con sus éxitos, sus problemas y sus posibilidades. Debo advertir que la bibliografía que acompaña el artículo, referida únicamente a las citas en él explicitadas, es totalmente insuficiente para dar razón de la visión de conjunto, nacida del poso que en mí ha dejado el estudio y análisis de cada uno de los sectores que conforman la realidad económica de Nicaragua en su vertiente productiva

Un siglo y medio de economía nicaragüense: las raíces del presente

Esta historia de Nicaragua, aunque con una breve referencia a la época colonial y su relación con el exterior, comienza en los años del “desarrollo hacia fuera”, protagonizados por el café y la pronta intervención norteamericana, a la que le hace frente Sandino y su ejército de hombres libres. Sigue con la época del crecimiento económico acelerado, bajo la égida del somocismo: los años de la posguerra, florecientes para Nicaragua como para la mayoría de países del mundo, haciendo especial énfasis en sus protagonistas locales, algodón, hamburguesas y Mercomún

Analysis of synoptic patterns in relationship with severe rainfall events in the Ebre Observatory (Catalonia)

The study has obtained a classification of the synoptic patterns associated with a selection of extreme rain episodes registered in the Ebre Observatory between 1905 and 2003, showing a return period of not less than 10 years for any duration from 5 min to 24 h. These episodes had been previously classified in four rainfall intensity groups attending to their meteorological time scale. The synoptic patterns related to every group have been obtained applying a multivariable analysis to three atmospheric levels: sea-level pressure, temperature, and geopotential at 500 hPa. Usually, the synoptic patterns associated with intense rain in southern Catalonia are featured by low-pressure systems advecting warm and wet air from the Mediterranean Sea at the low levels of the troposphere. The configuration in the middle levels of the troposphere is dominated by negative anomalies of geopotential, indicating the presence of a low or a cold front, and temperature anomalies, promoting the destabilization of the atmosphere. These configurations promote the occurrence of severe convective events due to the difference of temperature between the low and medium levels of troposphere and the contribution of humidity in the lowest levels of the atmosphere.Peer ReviewedPostprint (author's final draft

Virgin olive oil phenolic compounds modulate the HDL lipidome in hypercholesterolaemic subjects: a lipidomic analysis of the VOHF study

The lipidomic analysis of high-density lipoprotein (HDL) could be useful to identify new biomarkers of HDL function. Methods and results: A randomized, controlled, double-blind, crossover trial (33 hypercholesterolaemic subjects) is performed with a control virgin olive oil (VOO), VOO enriched with its own phenolic compounds (FVOO), or VOO enriched with additional phenolic compounds from thyme (FVOOT) for 3 weeks. HDL lipidomic analyses are performed using the Lipidyzer platform. VOO and FVOO intake increase monounsaturated-fatty acids (FAs) and decrease saturated and polyunsaturated FAs in triacylglyceride (TAG) species, among others species. In contrast, FVOOT intake does not induce these FAs changes. The decrease in TAG52:3(FA16:0) after VOO intake and the decrease in TAG52:5(FA18:2) after FVOO intake are inversely associated with changes in HDL resistance to oxidation. After FVOO intake, the decrease in TAG54:6(FA18:2) in HDL is inversely associated with changes in HDL cholesterol efflux capacity. Conclusion: VOO and FVOO consumption has an impact on the HDL lipidome, in particular TAG species. Although TAGs are minor components of HDL mass, the observed changes in TAG modulated HDL functionality towards a cardioprotective mode. The assessment of the HDL lipidome is a valuable approach to identify and characterize new biomarkers of HDL function.The VOHF project (AGL2009-13517-457 C03-01) and the AppleCOR Project (AGL2016-76943-C2) were made possible with the support of the Ministerio de Economía, Indústria y Competitividad, the Agencia Estatal de Investigación, and the European Regional Development Fund. U.C. has a Pla Estratègic de Recerca i Innovació en Salut (PERIS) postdoctoral grant (no. SLT002/16/00239; Catalunya, Spain) from the Generalitat de Catalunya. A.P. has a Torres Quevedo postdoctoral grant with the Subprograma Estatal de Incorporación, Plan Estatal de Investigación Científica Técnica y de Innovación. M.F. has a Sara Borrell postdoctoral contract (CD17/00233 to M.F.-St.Pau). O.C. has a JR17/00022 contract from Instituto de Salud Carlos III. CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) is a project of Instituto de Salud Carlos III (Madrid, Spain). The NFOC-Salut group is a consolidated research group of the Generalitat de Catalunya, Spain (reference no. 2017 SGR 522)

Análisis de las situaciones sinópticas correspondientes a episodios de lluvia severa en Barcelona

Postprint (published version

Prognostic value of hematogenous dissemination and biological profile of the tumor in early breast cancer patients: A prospective observational study

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to investigate the incidence and prognostic value of disseminated tumor cells in bone marrow of breast carcinoma patients with early disease, and to analyze this finding in relation to lymph node involvement, determined by sentinel lymph node (SLN) biopsy analysis, and to prognostic factors of interest.</p> <p>Methods</p> <p>104 patients with operable (T < 3 cm) breast cancer and clinically- and sonographically-negative axillary lymph nodes were scheduled for SLN biopsy. Bone marrow aspirates were collected before the start of surgery from both iliac crests, and mononuclear cell layers were separated by density centrifugation (Lymphoprep). Slide preparations were then examined for the presence of disseminated tumor cells by immunocytochemistry with anti-cytokeratin antibodies (A45-B/B3). Lymphoscintigraphy was performed 2 hours after intratumor administration of 2 mCi (74 MBq) of 99mTc colloidal albumin. The SLN was evaluated for the presence of tumor cells by hematoxylin-eosin staining and, when negative, by immunocytochemistry using anti-cytokeratin antibody (CAM 5.2). Survival analyses and comparative analyses were performed on the results of bone marrow determinations, SLN biopsy, and known prognostic factors, including breast cancer subtypes according to the simplified classification based on ER, PR and HER2.</p> <p>Results</p> <p>Lymph node and hematogenous dissemination occur in one-third of patients with early-stage breast cancer, although not necessarily simultaneously. In our study, disseminated tumor cells were identified in 22% of bone marrow aspirates, whereas 28% of patients had axillary lymph node involvement. Simultaneous lymph node and bone marrow involvement was found in only 5 patients (nonsignificant). In the survival study (60 months), a higher, although nonsignificant rate of disease-related events (13%) was seen in patients with disseminated tumor cells in bone marrow, and a significant association of events was documented with the known, more aggressive tumor subtypes: triple negative receptor status (21%) and positive ERBB2 status (29%).</p> <p>Conclusions</p> <p>Tumor cell detection in bone marrow can be considered a valid prognostic parameter in patients with early disease. However, the classic prognostic factors remain highly relevant, and the newer breast cancer subtypes are also useful for this purpose.</p

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER); Ministerio de Ciencia e Innovación; Gerencia Regional de Salud de Castilla y León (SACYL, GRS COVID 32/A/20).Aims Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. Methods 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. Results 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. Conclusions Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT0455656

Resumen Ejecutivo del tratamiento antibiótico domiciliario endovenoso: Directrices de la Sociedad Española de Enfermedades Infecciosas y la Sociedad Española de Hospitalización a Domicilio

Outpatient parenteral antimicrobial therapy (OPAT) programmes make it possible to start or complete intravenous antimicrobial therapy for practically any type of infection at home, provided that patient selection is appropriate for the type of OPAT programme available. Although the clinical management of infections in the home setting is comparable in many respects to that offered in conventional hospitalization (selection of antibiotics, duration of treatment, etc.), there are many aspects that are specific to this care modality. It is essential to be aware of them so that OPAT continues to be as safe and effective as inpatient care. The objective of this clinical guideline is therefore to provide evidence-and expert-based recommendations with a view to standardizing clinical practice in this care modality and contribute to a progressive increase in the number of patients who can be cared for and receive intravenous therapy in their own homes.Los programas de tratamiento antibiótico domiciliario endovenoso (TADE) permiten iniciar o completar el tratamiento antimicrobiano por vía endovenosa de prácticamente cualquier tipo de infección en el domicilio, siempre y cuando se realice una selección del paciente acorde al tipo de programa de TADE que se dispone. Aunque hay aspectos del manejo clínico de las infecciones en el domicilio que son superponibles en la mayoría de los casos a la realizada en la hospitalización convencional (selección de la antibioterapia, duración del tratamiento, etc.), existen numerosos aspectos que son específicos de esta modalidad asistencial. Resulta imprescindible conocerlos para que el TADE siga siendo igual de eficaz y seguro que la hospitalización convencional. El objetivo de esta guía clínica es por tanto proporcionar recomendaciones basadas en la evidencia realizadas por expertos para homogeneizar la práctica clínica de esta modalidad asistencial y contribuir a que se incremente progresivamente el número de pacientes que pueden ser atendidos y recibir tratamiento endovenoso en su propio domicilio