Geometrothermodynamics

We present the fundamentals of geometrothermodynamics, an approach to study the properties of thermodynamic systems in terms of differential geometric concepts. It is based, on the one hand, upon the well-known contact structure of the thermodynamic phase space and, on the other hand, on the metric structure of the space of thermodynamic equilibrium states. In order to make these two structures compatible we introduce a Legendre invariant set of metrics in the phase space, and demand that their pullback generates metrics on the space of equilibrium states. We show that Weinhold's metric, which was introduced {\it ad hoc}, is not contained within this invariant set. We propose alternative metrics which allow us to redefine the concept of thermodynamic length in an invariant manner and to study phase transitions in terms of curvature singularities.Comment: Revised version, to be published in Jour. Math. Phy

Riesgo de inundación en la subcuenca del río La Antigua, Veracr z, México

El objetivo del presente trabajo fue aplicar el modelo de simulación hidráulica HEC-RAS para delimitar las zonas con riesgo a inundación en la subcuenca del río La Antigua, Veracruz, México, utilizando la metodología del Centro Nacional de Prevención de Desastres (Cenapred), que considera la vulnerabilidad y el peligro de un sistema ante la ocurrencia de un fenómeno extremo perturbador. El modelo HEC-RAS usa ecuaciones diferenciales determinísticas que simulan el comportamiento y la dinámica de los niveles de agua en secciones transversales del cauce; su aplicación bajo condiciones de flujo no permanente y régimen mixto permitió definir las áreas de inundación alcanzadas durante una avenida extraordinaria. Para la simulación hidráulica se construyeron hidrogramas unitarios sintéticos con datos de precipitación registrados durante un evento hidrometeorológico extremo; la geometría del cauce se obtuvo con la extensión HEC-GeoRAS, herramienta que extrajo y procesó información georreferenciada del Modelo Digital de Elevación (MDE) LiDAR tipo terreno y los coeficientes de rugosidad (h de Manning) se estimaron de acuerdo con las características físicas del canal. Para calibrar los datos estimados por el modelo se utilizó información hidrométrica (niveles registrados) de la estación 28003 Cardel. La aplicación de tres estadísticas de prueba: R, RMSE y DMA demostraron un alto ajuste entre datos observados versus simulados, respaldando la aplicabilidad del modelo HEC-RAS para simular, predecir y delimitar zonas de riesgo a inundación

Health care utilisation and problems in accessing health care of female undocumented immigrants in the Netherlands

Contains fulltext : 88419.pdf (publisher's version ) (Closed access)OBJECTIVE: To obtain information about the actual use of health care facilities by undocumented women and to identify obstacles they experience in accessing health care facilities. METHODS: A mixed methods study, with structured questionnaires and semi-structured interviews, was chosen to obtain a complete understanding. One-hundred undocumented women were recruited. Diversity was sought according to age, origin and reason for being undocumented. RESULTS: Undocumented female immigrants have unmet health care needs (56%) and low health care utilisation. Sixty-nine per cent of the women reported obstacles in accessing health care facilities. These included many personal obstacles such as shame, fear and/or lack of information. Poor language proficiency (OR 0.28;. CI 0.09-0.90) reduces utilisation of primary health care services. CONCLUSION: Health care utilisation of undocumented women is low. Undocumented women refrain from seeking health care because of personal obstacles. These women need to be identified and informed about their rights, the health care system and the duty of professional confidentiality of doctors. Finally, institutional obstacles to access care should be removed since they strengthen reluctance to seek help.1 oktober 201

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Carta de Psicología No. 52

40 páginasCómo saber cuán buena es la calidad de la educación en Colombia? Esta es la pregunta que se formularon los expertos en medición y pedagogía a principios de la década del ochenta, ante la necesidad de desarrollar indicadores que permitieran evaluar la calidad de los programas ofrecidos a lo largo del país. A pesar de que en esa época el Instituto Colombiano para el Fomento de la Educación Superior (Icfes) hacía pruebas de ingreso a la educación superior, no se evaluaba a los estudiantes en el momento de egresar para determinar la calidad de la formación recibida en su paso por las universidades públicas (Icfes, 2019). La travesía de implementar un modelo de evaluación de la educación inició con pequeños muestreos en municipios de todo el país. En estos se pretendía detectar el desarrollo de capacidades y competencias, para brindar un insumo a las instituciones de educación y que estas pudieran diseñar estrategias para cumplir con los estándares de calidad esperados para la época (Icfes, 2019). Una vez establecidas las primeras metodologías muestrales, el sistema adquirió un carácter más robusto que, a inicios del presente siglo, permitió censar a todos los estudiantes colombianos mediante los exámenes de calidad de la educación nacional en Colombia (Ecaes) (Icfes, 2019). Con el desarrollo de nuevas tecnologías y el mejoramiento de la cobertura de Internet en el ámbito nacional, la tarea del Icfes se ha modernizado para diligenciar digitalmente los procesos de inscripción y recaudo. En el año 2009 se instituyó el mecanismo de las pruebas Saber como un sistema transversal a todos los niveles educativos (Icfes, 2019).CEIPS. Pruebas Saber: más allá de una evaluación... 1 Camila Garzón Emprendimiento: una oportunidad para el desarrollo profesional ..3 Carlos Alberto Gómez Rada Semilleros Semillas de Infancia. ..5 Leidy Natalia García; María Paula García; Jefferson Morales; Stiven Pérez; Paola Remolina; Karol Salinas Líder Juan Carlos Sarmiento Reyes Relación entre habilidades de inhibición y comportamiento altruista ...9 Leidy Johana Álvarez Leguizamón Líder: David Aguilar Análisis estadístico de la violencia interpersonal durante los años 2015, 2016 y 2017...14 Natalia Rodríguez Garnica; Paula Virginia Torres Pachón Líder: Ever José López Cantera Adolescencia, juventud y el Sistema de responsabilidad penal para adolescentes (SRPA) en Colombia ...19 Xiomara González Alarcón Líder: Julián Camilo Sarmiento López Niños habitantes de calle. .22 Valentina Quevedo Modificabilidad y enseñanza de la ortografía ...26 John Alejandro Sabogal Ardila, Adriana Carolina Santos Acevedo Líder: Olga Romero Errores de pensamiento: una guía práctica de conocimiento ..28 Karen Yineth Bernal Manrique, Daniela Gualtero Salazar, Jhoan Sebastián López Sepúlveda, Geraldine Sánchez Torres Líder: Olga Romero Empoderamiento lingüístico en el contexto educativo ...29 María Fernanda Trujillo Amaya, Gabriela Gutiérrez Paiba Líder: Olga Romero Enseñanza de la orientación espacial ..32 Daniela Bautista Riveros, Alexandra Forero Cruz, Diana Gómez Forero Líder: Olga Romero Solución de problemas, perspectivas e integración teórica... 35 Cristian Rincón, Valentina Gómez Líder: Olga Romero Deterioro cognitivo leve ...37 Danna Gabriela Aguilar Velandia Líder: Sandra Milena Camelo Roa Medios de comunicación en la salud alimentaria en niños...39 Luisa Fernanda D’Achiardi Gómez, Laura Melissa Arévalo Moreno Líder: Andrés Mauricio Santacoloma Suáre

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

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

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 middle-income 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 low-income 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 low-income, 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