Influencia sobre el cortante basal y derivas de edificaciones al incluir una fracción de la carga viva en la carga sísmica reactiva

This article studies the impact on the base shear and floor drift when including a fraction of the live load in the effective seismic weight. The analyses consider the variation in the building period of vibration due to an increase in the effective seismic weight; the corresponding changes in the spectral acceleration and base shear are evaluated using the elastic design spectrum given by the Ecuadorian seismic code, for three different locations and a selected type of soil. Analyses were also conducted in several low-rise structures to study the changes in the drift. It was found that including a fraction of the live load in the effective seismic weight produces an increase in the base shear and drifts; the magnitude of such increase depends on the building period of vibration, and the relation between live and dead loads.Este artículo estudia el impacto sobre el cortante basal y la deriva de piso al incluir una fracción de carga viva en el cálculo de la carga sísmica reactiva. Los análisis incluyen la variación del periodo de vibración causada por un incremento en la carga reactiva; la correspondiente variación en la aceleración espectral y el cortante basal se evalúa utilizando el espectro elástico de diseño de la normativa sismorresistente de Ecuador para tres ubicaciones distintas y un tipo de suelo seleccionado. Análisis fueron conducidos en múltiples estructuras de baja altura para investigar los cambios en las derivas. Se encontró que la inclusión de una fracción de la carga viva en la carga reactiva conlleva a un incremento del cortante basal y derivas; la magnitud de este incremento depende de la ubicación del periodo estructural respecto al periodo donde termina la zona de aceleración espectral constante, y la relación entre carga viva y muerta de la estructura

Influencia de los medios de comunicación y redes sociales en la adopción de conductas adictivas en adolescentes

Addictive behaviors may include the use of substances such as drugs or alcohol, as well as participation in activities such as compulsive gambling, excessive use of technology, problematic eating behaviors and the search for instant gratification. Study design: Descriptive documentary design. Objective: To analyze the influence of the media and social networks on the adoption of addictive behaviors in adolescents. Results: The media that promote addictive behaviors are Facebook, Twitter, Instagram, Whatsapp, Youtube. The main consequences of addictive behaviors presented by adolescents are psychological damage to a greater extent, other behaviors are gambling, low academic and work performance, lying, poor achievement, social isolation and fatigue. The most serious behaviors found are suicidal behaviors, stress, bullying and substance abuse. the strategies used by the media, most of them use shocking headlines and sensationalist content. Conclusion: Social networks such as Facebook, Twitter and Instagram provide instant gratification through likes, comments and notifications, which can lead to a constant search for validation and rewards, motivating addiction. Addiction can lead to mental health issues such as anxiety, depression and low self-esteem. Constant exposure to edited images and beauty standards on social media can lead to self-image and self-esteem issues. When it comes to social and media strategies aimed at normalizing addictive behaviors, platforms use reward mechanisms such as likes, comments and notifications to provide instant gratification, and seek recognition on social networks.Los comportamientos adictivos pueden incluir el uso de sustancias como las drogas o el alcohol, así como la participación en actividades como el juego compulsivo, el uso excesivo de la tecnología, los comportamientos alimentarios problemáticos y la búsqueda de gratificación instantánea. Diseño de estudio: Diseño documental tipo descriptivo. Objetivo: Analizar influencia de los medios de comunicación y las redes sociales en la adopción de conductas adictivas en adolescentes. Resultados: Los Medios de comunicación que promueven conductas adictivas son Facebook, Twitter, Instagram, Whatsapp, Youtube. Las principales consecuencias de conductas adictivas que presentan los adolescentes son daños psicológicos en mayor medida, otras conductas son ludopatía, bajo rendimiento académico, laboral, mentiras, logros pobres, aislamiento social y fatiga. Las conductas más graves encontradas son conductas suicidas, estrés, acoso escolar y consumo de sustancias. las estrategias utilizadas por los medios de comunicación, la mayoría utiliza titulares impactantes y contenido sensacionalista. Conclusión: Las redes sociales como Facebook, Twitter e Instagram brindan gratificación instantánea a través de me gusta, comentarios y notificaciones, lo que puede llevar a una búsqueda constante de validación y recompensas, motivando adictivamente. La adicción puede provocar problemas de salud mental como ansiedad, depresión y baja autoestima. La exposición constante a imágenes editadas y estándares de belleza en las redes sociales puede provocar problemas de autoimagen y autoestima. Cuando se trata de estrategias sociales y mediáticas destinadas a normalizar conductas adictivas, las plataformas utilizan mecanismos de recompensa como me gusta, comentarios y notificaciones para brindar gratificación instantánea, y buscar reconocimiento en las redes sociales

Coinfección entre virus de Inmunodeficiencia Humana e infecciones fúngicas oportunistas en adictos crónicos

A chronic addiction is when an individual can relapse, that is, return to using drugs when trying to quit. While the Human Immunodeficiency Virus (HIV) attacks white blood cells, weakening the immune system, making it easier to contract diseases such as tuberculosis, or others such as cancer. Opportunistic infections are the most important complications in individuals with HIV; however, the characteristic differences of these patients mean that the prevalence of opportunistic infection varies depending on the region. The objective was to determine the coinfection between Human Immunodeficiency Virus and opportunistic fungal infections in chronic addicts. The research had a descriptive documentary design based mainly on a systematic review. As results, different risk factors for fungal infection could be observed, among them a high viral load, cirrhosis, among others. While the most common fungal infections were Candida, particularly Candida albicans. Another is onychomycosis and histoplasmosis. While the most used diagnostic methods are culture, PCR and clinical examination and Wood's light. It was concluded that coinfection between human immunodeficiency virus and opportunistic fungal infections is a complex that requires careful evaluation of each individual case. However, in general, it has been observed that the presence of opportunistic fungal infections in chronic addicts with HIV can complicate clinical management and increase morbidity and mortality.Una adicción crónica es cuando un individuo puede tener una recaída, es decir, volver a consumir drogas cuando se intenta dejarla. Mientras que el Virus de Inmunodeficiencia Humana (VIH) ataca a los glóbulos blancos, y así, debilitando al sistema inmune, haciendo que sea más fácil contraer enfermedades como la tuberculosis, u otras como el cáncer. Las infecciones oportunistas son las complicaciones más importantes en individuos con VIH, sin embargo, las diferencias características de estos pacientes hacen que la prevalencia de la infección oportunista varie según las regiones. El objetivo fue determinar la coinfección entre virus de Inmunodeficiencia Humana e infecciones fúngicas oportunistas en adictos crónicos. La investigación fue de diseño documental tipo descriptivo basado principalmente en una revisión sistemática. Como resultados, se pudo observar los diferentes factores de riesgo para infección fúngica, entre esos se presentó una carga viral alta, cirrosis, entre otras. Mientras que las infecciones fúngicas más frecuentes fueron Cándida, particularmente Cándida albicans. Otra es la onicomicosis e histoplasmosis. Mientras que los métodos diagnósticos más utilizados es el cultivo, la PCR y el examen clínico y con luz de Wood. Se pudo concluir que, la coinfección entre el virus de la inmunodeficiencia humana y las infecciones fúngicas oportunistas es un complejo que requiere una evaluación cuidadosa de cada caso individual. Sin embargo, en general, se ha observado que la presencia de infecciones fúngicas oportunistas en adictos crónicos con VIH puede complicar el manejo clínico y aumentar la morbimortalidad

Efficacy and safety of long-term treatment with low-dose rituximab for relapsing mixed cryoglobulinemia vasculitis

This study aims to evaluate the efficacy and safety of repeated treatments with low-dose rituximab for relapsing mixed cryoglobulinemia vasculitis. Thirty-seven patients with mixed cryoglobulinemia vasculitis refractory to standard of care treatment, 34 of which were HCV-positive, were treated with rituximab at the reduced dosage of 250 mg/m2 given twice 1 week apart per cycle. Thirty patients (81%) achieved a clinical response; 5 of them remain in remission, 3 were lost to follow-up or died, and 22 relapsed after a mean of 15.7 months. Eleven relapsers were retreated with one (6 patients), 2 (3 patients), or 3 (2 patients) additional rituximab cycles given at each relapse. Clinical and laboratory efficacy and side effects of long-term treatment were evaluated. Clinical response to retreatment was 91% (10/11) at the first relapse, 80% (4/5) at the second relapse, and 100% (2/2) at the third relapse. The mean (±SD) time to relapse was 17.1 ± 14.1 months in 30 patients who were treated with only one cycle (from first cycle to the first relapse) and 45.7 ± 30.6 months (from first cycle to the last observed relapse) in 11 patients treated with 2 or more cycles (p = 0.0037). Severe adverse reactions occurred in 3 patients, in 2 of whom at the first cycle. Our results suggest that repeated treatment of relapsing mixed cryoglobulinemia with a low-dose rituximab regimen is efficacious, safe, and cost-effective for the long-term management of this disorder

Arte y ecología política

En la literatura, las artes plásticas y el cine, igual que en la acción democrática, lo que está en juego es la posibilidad de alterar las formas hegemónicas de experiencia del mundo y así dar visibilidad a todo aquello que suele ser excluido de los marcos consensuales de percepción. En Argentina y a lo largo de América Latina, la reciente expansión de la frontera extractiva ha puesto en jaque los derechos territoriales y la salud colectiva. Es preciso poner en discusión esa lógica sacrificial que subordina la vida humana y no humana a la apropiación y explotación intensiva de la naturaleza. Es una tarea que requiere repoblar nuestra imaginación para hacer lugar a mundos alternativos. Arte y ecología política constituye el primer volumen de su tipo pues reúne ensayos, crónicas e investigaciones que bucean en diferentes aspectos estéticos y expresivos que hacen espacio a otras formas de vivir más justas y sustentables

Outcomes of Early Versus Late Tracheostomy in Patients With COVID-19: A Multinational Cohort Study.

UNLABELLED: Timing of tracheostomy in patients with COVID-19 has attracted substantial attention. Initial guidelines recommended delaying or avoiding tracheostomy due to the potential for particle aerosolization and theoretical risk to providers. However, early tracheostomy could improve patient outcomes and alleviate resource shortages. This study compares outcomes in a diverse population of hospitalized COVID-19 patients who underwent tracheostomy either early (within 14 d of intubation) or late (more than 14 d after intubation). DESIGN: International multi-institute retrospective cohort study. SETTING: Thirteen hospitals in Bolivia, Brazil, Spain, and the United States. PATIENTS: Hospitalized patients with COVID-19 undergoing early or late tracheostomy between March 1, 2020, and March 31, 2021. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: A total of 549 patients from 13 hospitals in four countries were included in the final analysis. Multivariable regression analysis showed that early tracheostomy was associated with a 12-day decrease in time on mechanical ventilation (95% CI, -16 to -8; p \u3c 0.001). Further, ICU and hospital lengths of stay in patients undergoing early tracheostomy were 15 days (95% CI, -23 to -9 d; p \u3c 0.001) and 22 days (95% CI, -31 to -12 d) shorter, respectively. In contrast, early tracheostomy patients experienced lower risk-adjusted survival at 30-day post-admission (hazard ratio, 3.0; 95% CI, 1.8-5.2). Differences in 90-day post-admission survival were not identified. CONCLUSIONS: COVID-19 patients undergoing tracheostomy within 14 days of intubation have reduced ventilator dependence as well as reduced lengths of stay. However, early tracheostomy patients experienced lower 30-day survival. Future efforts should identify patients most likely to benefit from early tracheostomy while accounting for location-specific capacity

Outcomes of Early Versus Late Tracheostomy in Patients With COVID-19: A Multinational Cohort Study

Objectives:. Timing of tracheostomy in patients with COVID-19 has attracted substantial attention. Initial guidelines recommended delaying or avoiding tracheostomy due to the potential for particle aerosolization and theoretical risk to providers. However, early tracheostomy could improve patient outcomes and alleviate resource shortages. This study compares outcomes in a diverse population of hospitalized COVID-19 patients who underwent tracheostomy either “early” (within 14 d of intubation) or “late” (more than 14 d after intubation). Design:. International multi-institute retrospective cohort study. Setting:. Thirteen hospitals in Bolivia, Brazil, Spain, and the United States. Patients:. Hospitalized patients with COVID-19 undergoing early or late tracheostomy between March 1, 2020, and March 31, 2021. Interventions:. Not applicable. Measurements and Main Results:. A total of 549 patients from 13 hospitals in four countries were included in the final analysis. Multivariable regression analysis showed that early tracheostomy was associated with a 12-day decrease in time on mechanical ventilation (95% CI, −16 to −8; p < 0.001). Further, ICU and hospital lengths of stay in patients undergoing early tracheostomy were 15 days (95% CI, −23 to −9 d; p < 0.001) and 22 days (95% CI, −31 to −12 d) shorter, respectively. In contrast, early tracheostomy patients experienced lower risk-adjusted survival at 30-day post-admission (hazard ratio, 3.0; 95% CI, 1.8−5.2). Differences in 90-day post-admission survival were not identified. Conclusions:. COVID-19 patients undergoing tracheostomy within 14 days of intubation have reduced ventilator dependence as well as reduced lengths of stay. However, early tracheostomy patients experienced lower 30-day survival. Future efforts should identify patients most likely to benefit from early tracheostomy while accounting for location-specific capacity