Frugal Leafy Green Shredding & Washing Machines

The goal of this project is to create specialized frugal appliances to assist women in rural Cameroon by reducing the amount of time it takes to prepare food. Specifically, the project focuses on two tasks: slicing eru leaves and washing bitter leaves. After researching the market and collecting information from women in South Cameroon, two appliances were designed: an eru leaf shredder and a bitter leaf washer. The shredder is a manual shredding device that uses a rotating blade and shaft subsystem to slice leaves, reducing labor time by 62% and increasing safety with features such as a hopper and an ergonomic crank handle. The washer is a manual washing device that features a rotating agitator that reduces the amount of time taken to wash bitter leaves by 50% and reduces the amount of water usage by 75%. Both devices are held in a portable housing unit that allows them to be easily moved and stored

Violencia familiar y agresividad en estudiantes de secundaria de una Institución Pública-Yungay, 2020

El presente trabajo de investigación tiene como objetivo general determinar la relación entre la violencia familiar y agresividad en estudiantes de secundaria de una Institución Pública-Yungay, 2020. La muestra estuvo comprendida por 300 estudiantes de nivel secundario de ambos sexos, sus edades oscilan entre 11 a 18 años; es de vital importancia mencionar que en el presente trabajo se empleó un diseño no experimental, de tipo descriptivo - correlacional. Las pruebas que se emplearon fueron los siguientes: el cuestionario peruano de violencia familiar “VIFA” de Altamirano y Ortega, está compuesta por 20 ítems, por consiguiente, se usó el cuestionario de agresión de Buss y Perry, adaptado a la realidad peruana, consta de 29 ítems. En los resultados se usó el análisis de Rho de Spearman, obteniendo una correlación moderada (r= 0,427), además la significancia es de p=0.000 donde muestra que la relación es significativa, entonces podemos decir que a mayor violencia mayor agresividad de esta manera se rechaza la hipótesis nula y se afirma que existe correlación entre violencia familiar y agresividad en estudiantes de una institución pública-Yungay, 2020

Siembra directa de árboles nativos para la restauración de la selva estacionalmente seca

Background and Aims: Dry forest is in extreme need of restoration given its high deforestation rates. For its restoration, direct seeding, which refers to the sowing of seeds directly in the soil, has been suggested. The objective of this study was to evaluate the success of direct seeding of nine native tree species.Methods: Emergency was evaluated for 30 days and survival for one year for four early-successional and five late-successional tree species sown in habitats with different cover of herbs and trees in two areas under restoration in Morelos and Puebla, Mexico. Key results: The most successful species given emergence and seedling survival were the early successional trees Spondias purpurea (16.79%) in El Limón, and Senegalia macilenta (20.38%) in Teotlalco; the other tree species had <10% of success. In both localities, successional status of the sown tree species was not a good predictor of emergence percentage. The cover of herbaceous and trees favored the emergence of late-successional species, while the early-successional species did not respond to plant cover; the opposite was true for seedling survival: late-successional species did not respond to plant cover changes.Conclusions: The highest mortality was registered in those areas without restoration intervention due in part, to the lack of plant cover. Also, since tree performance varied greatly by successional status and among covers, we recommend: 1) using different combination of early and late-successional tree species for direct seeding under contrasting covers and 2) establishing a cover with fast-growing trees under which the seeds of species that benefit from shade are sown and 3) to favor natural succession to increase the success of direct seeding.Antecedentes y Objetivos: La selva estacionalmente seca requiere de acciones de restauración dadas sus altas tasas de deforestación. Para su restauración se ha sugerido el uso de la siembra directa, que se refiere a la colocación de semillas directamente en el suelo. El objetivo de este trabajo fue evaluar el éxito de la siembra directa de semillas de árboles de nueve especies nativas.Métodos: La emergencia se evaluó durante 30 días y la sobrevivencia después de un año para cuatro especies sucesionales tempranas y cinco tardías sembradas en hábitats con distinta cobertura de hierbas y árboles en dos áreas bajo restauración en Morelos y Puebla, México. Resultados clave: Las especies más exitosas por su emergencia y sobrevivencia de plántulas fueron las sucesionales tempranas: Spondias purpurea (16.79%) en El Limón y Senegalia macilenta (20.38%) en Teotlalco; el resto de las especies presentaron porcentajes de éxito de <10%. En ambas localidades, el estatus sucesional de las especies no explicó el porcentaje de emergencia. La cobertura de hierbas y árboles favoreció la emergencia de las especies tardías, mientras que las tempranas no respondieron a la cobertura; lo opuesto se observó con la sobrevivencia de las plántulas: las tardías no respondieron a los cambios en la cobertura vegetal.Conclusiones: La mayor mortalidad de plántulas se registró en los sitios sin intervención de restauración, debido en parte a la falta de cobertura vegetal. Dado que el éxito de las especies por estatus sucesional y entre coberturas fue altamente variable, se recomienda: 1) usar distintas combinaciones de semillas de especies tempranas y tardías para la siembra directa bajo coberturas contrastantes, 2) establecer una cobertura con árboles de rápido crecimiento bajo la cual se siembren las semillas de especies que se benefician de la sombra y, 3) favorecer la sucesión natural para aumentar el éxito de la siembra directa

Unidades de cuidados paliativos en el Perú

Acceso restringido. Si desea contactar a una de los autoras, escriba a [email protected] para reenviar su mensaje.Los cuidados paliativos (CP) especializados son prestados bajo una organización y gestión diferenciadas del resto de servicios asistenciales, con profesionales que tienen formación avanzada en este tipo de asistencia, y que cuenta con recursos físicos y financieros específicos con la finalidad de mejorar la atención; puede estar englobada en un servicio de CP que integre el equipo de soporte hospitalario y/o al equipo de soporte de atención domiciliaria. El elemento fundamental de la gestión de UCP es su integración en una red de servicios especializados de CP y coordinación con el ámbito de atención primaria, atención especializada y los recursos sociales disponibles, que garantice la continuidad de la asistencia. Las ventajas y desventajas de cada modelo organizativo de UCP deben ser considerados en función del modelo de provisión de servicios de cuidados paliativos, organización del hospital y servicios de salud correspondientes, su disponibilidad del recurso y adaptación a cada entorno geográfico y poblacional. La descripción de la organización de la UCP se articula en relación con el proceso de atención al paciente: acceso a la unidad, circulación dentro de la unidad y derivaciones post alta. A lo largo del seguimiento del manejo del paciente en el entorno y dentro de la UCP se dan alternativas organizativas y de gestión distintas. Cada organización sanitaria deberá dar prioridad a las alternativas más adecuadas a su sistema organizativo y de gestión. El paciente y su familia es una unidad básica terapéutica en CP. Se considera una arista importante de abordar en el manejo paliativo, constituyéndose un eje primordial para el logro de los objetivos. En ella encontraremos el primer nivel de cuidados, generalmente al cuidador principal y/o secundarios; y es la unidad dentro de la comunidad en donde se da el desarrollo de hasta el 80% de los cuidados. El Atlas latinoamericano de CP elaborado por la ALCP, muestra que el nivel de desarrollo de los CP en el Perú corresponde al grupo de países de provisión aislada, es decir no existe una red nacional que permita el acceso universal. Se presenta una distribución asimétrica a nivel nacional de los Servicios/ Unidades de CP, los mismos que se concentran en establecimientos de segundo y tercer nivel, y en su mayoría centralizados en la ciudad de Lima.Trabajo de investigació

Genetic diversity and connectivity of southern right whales (Eubalaena australis) found in the Brazil and Chile-Peru wintering grounds and the South Georgia (Islas Georgias del Sur) feeding ground

As species recover from exploitation, continued assessments of connectivity and population structure are warranted to provide information for conservation and management. This is particularly true in species with high dispersal capacity, such as migratory whales, where patterns of connectivity could change rapidly. Here we build on a previous long-term, large-scale collaboration on southern right whales (Eubalaena australis) to combine new (nnew) and published (npub) mitochondrial (mtDNA) and microsatellite genetic data from all major wintering grounds and, uniquely, the South Georgia (Islas Georgias del Sur: SG) feeding grounds. Specifically, we include data from Argentina (npub mtDNA/microsatellite=208/46), Brazil (nnew mtDNA/microsatellite=50/50), South Africa (nnew mtDNA/microsatellite=66/77, npub mtDNA/microsatellite=350/47), Chile-Peru (nnew mtDNA/microsatellite=1/1), the Indo-Pacific (npub mtDNA/microsatellite=769/126), and SG (npub mtDNA/microsatellite=8/0, nnew mtDNA/microsatellite=3/11) to investigate the position of previously unstudied habitats in the migratory network: Brazil, SG and Chile-Peru. These new genetic data show connectivity between Brazil and Argentina, exemplified by weak genetic differentiation and the movement of one genetically identified individual between the South American grounds. The single sample from Chile-Peru had a mtDNA haplotype previously only observed in the Indo-Pacific and had a nuclear genotype that appeared admixed between the Indo-Pacific and South Atlantic, based on genetic clustering and assignment algorithms. The SG samples were clearly South Atlantic, and were more similar to the South American than the South African wintering grounds. This study highlights how international collaborations are critical to provide context for emerging or recovering regions, like the SG feeding ground, as well as those that remain critically endangered, such as Chile-Peru

Study protocol for the recreational stimulation for elders as a vehicle to resolve delirium superimposed on dementia (Reserve For DSD) trial

<p>Abstract</p> <p>Background</p> <p>Delirium is a state of confusion characterized by an acute and fluctuating decline in cognitive functioning. Delirium is common and deadly in older adults with dementia, and is often referred to as delirium superimposed on dementia, or DSD. Interventions that treat DSD are not well-developed because the mechanisms involved in its etiology are not completely understood. We have developed a theory-based intervention for DSD that is derived from the literature on cognitive reserve and based on our prior interdisciplinary work on delirium, recreational activities, and cognitive stimulation in people with dementia. Our preliminary work indicate that use of simple, cognitively stimulating activities may help resolve delirium by helping to focus inattention, the primary neuropsychological deficit in delirium. Our primary aim in this trial is to test the efficacy of Recreational Stimulation for Elders as a Vehicle to resolve DSD (RESERVE- DSD).</p> <p>Methods/Design</p> <p>This randomized repeated measures clinical trial will involve participants being recruited and enrolled at the time of admission to post acute care. We will randomize 256 subjects to intervention (RESERVE-DSD) or control (usual care). Intervention subjects will receive 30-minute sessions of tailored cognitively stimulating recreational activities for up to 30 days. We hypothesize that subjects who receive RESERVE-DSD will have: decreased severity and duration of delirium; greater gains in attention, orientation, memory, abstract thinking, and executive functioning; and greater gains in physical function compared to subjects with DSD who receive usual care. We will also evaluate potential moderators of intervention efficacy (lifetime of complex mental activities and APOE status). Our secondary aim is to describe the costs associated with RESERVE-DSD.</p> <p>Discussion</p> <p>Our theory-based intervention, which uses simple, inexpensive recreational activities for delivering cognitive stimulation, is innovative because, to our knowledge it has not been tested as a treatment for DSD. This novel intervention for DSD builds on our prior delirium, recreational activity and cognitive stimulation research, and draws support from cognitive reserve theory.</p> <p>Trial registration</p> <p>ClinicalTrials.gov identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01267682">NCT01267682</a></p

Isolation, Cloning and Structural Characterisation of Boophilin, a Multifunctional Kunitz-Type Proteinase Inhibitor from the Cattle Tick

Inhibitors of coagulation factors from blood-feeding animals display a wide variety of structural motifs and inhibition mechanisms. We have isolated a novel inhibitor from the cattle tick Boophilus microplus, one of the most widespread parasites of farm animals. The inhibitor, which we have termed boophilin, has been cloned and overexpressed in Escherichia coli. Mature boophilin is composed of two canonical Kunitz-type domains, and inhibits not only the major procoagulant enzyme, thrombin, but in addition, and by contrast to all other previously characterised natural thrombin inhibitors, significantly interferes with the proteolytic activity of other serine proteinases such as trypsin and plasmin. The crystal structure of the bovine α-thrombin·boophilin complex, refined at 2.35 Å resolution reveals a non-canonical binding mode to the proteinase. The N-terminal region of the mature inhibitor, Q16-R17-N18, binds in a parallel manner across the active site of the proteinase, with the guanidinium group of R17 anchored in the S1 pocket, while the C-terminal Kunitz domain is negatively charged and docks into the basic exosite I of thrombin. This binding mode resembles the previously characterised thrombin inhibitor, ornithodorin which, unlike boophilin, is composed of two distorted Kunitz modules. Unexpectedly, both boophilin domains adopt markedly different orientations when compared to those of ornithodorin, in its complex with thrombin. The N-terminal boophilin domain rotates 9° and is displaced by 6 Å, while the C-terminal domain rotates almost 6° accompanied by a 3 Å displacement. The reactive-site loop of the N-terminal Kunitz domain of boophilin with its P1 residue, K31, is fully solvent exposed and could thus bind a second trypsin-like proteinase without sterical restraints. This finding explains the formation of a ternary thrombin·boophilin·trypsin complex, and suggests a mechanism for prothrombinase inhibition in vivo

Systematic Collaborative Reanalysis of Genomic Data Improves Diagnostic Yield in Neurologic Rare Diseases

Altres ajuts: Generalitat de Catalunya, Departament de Salut; Generalitat de Catalunya, Departament d'Empresa i Coneixement i CERCA Program; Ministerio de Ciencia e Innovación; Instituto Nacional de Bioinformática; ELIXIR Implementation Studies (CNAG-CRG); Centro de Investigaciones Biomédicas en Red de Enfermedades Raras; Centro de Excelencia Severo Ochoa; European Regional Development Fund (FEDER).Many patients experiencing a rare disease remain undiagnosed even after genomic testing. Reanalysis of existing genomic data has shown to increase diagnostic yield, although there are few systematic and comprehensive reanalysis efforts that enable collaborative interpretation and future reinterpretation. The Undiagnosed Rare Disease Program of Catalonia project collated previously inconclusive good quality genomic data (panels, exomes, and genomes) and standardized phenotypic profiles from 323 families (543 individuals) with a neurologic rare disease. The data were reanalyzed systematically to identify relatedness, runs of homozygosity, consanguinity, single-nucleotide variants, insertions and deletions, and copy number variants. Data were shared and collaboratively interpreted within the consortium through a customized Genome-Phenome Analysis Platform, which also enables future data reinterpretation. Reanalysis of existing genomic data provided a diagnosis for 20.7% of the patients, including 1.8% diagnosed after the generation of additional genomic data to identify a second pathogenic heterozygous variant. Diagnostic rate was significantly higher for family-based exome/genome reanalysis compared with singleton panels. Most new diagnoses were attributable to recent gene-disease associations (50.8%), additional or improved bioinformatic analysis (19.7%), and standardized phenotyping data integrated within the Undiagnosed Rare Disease Program of Catalonia Genome-Phenome Analysis Platform functionalities (18%)

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Evaluation of factors leading to poor outcomes for pediatric acute lymphoblastic leukemia in Mexico: a multi-institutional report of 2,116 patients

Background and aimsPediatric acute lymphoblastic leukemia (ALL) survival rates in low- and middle-income countries are lower due to deficiencies in multilevel factors, including access to timely diagnosis, risk-stratified therapy, and comprehensive supportive care. This retrospective study aimed to analyze outcomes for pediatric ALL at 16 centers in Mexico.MethodsPatients &lt;18 years of age with newly diagnosed B- and T-cell ALL treated between January 2011 and December 2019 were included. Clinical and biological characteristics and their association with outcomes were examined.ResultsOverall, 2,116 patients with a median age of 6.3 years were included. B-cell immunophenotype was identified in 1,889 (89.3%) patients. The median white blood cells at diagnosis were 11.2.5 × 103/mm3. CNS-1 status was reported in 1,810 (85.5%), CNS-2 in 67 (3.2%), and CNS-3 in 61 (2.9%). A total of 1,488 patients (70.4%) were classified as high-risk at diagnosis. However, in 52.5% (991/1,889) of patients with B-cell ALL, the reported risk group did not match the calculated risk group allocation based on National Cancer Institute (NCI) criteria. Fluorescence in situ hybridization (FISH) and PCR tests were performed for 407 (19.2%) and 736 (34.8%) patients, respectively. Minimal residual disease (MRD) during induction was performed in 1,158 patients (54.7%). The median follow-up was 3.7 years. During induction, 191 patients died (9.1%), and 45 patients (2.1%) experienced induction failure. A total of 365 deaths (17.3%) occurred, including 174 deaths after remission. Six percent (176) of patients abandoned treatment. The 5-year event-free survival (EFS) was 58.9% ± 1.7% for B-cell ALL and 47.4% ± 5.9% for T-cell ALL, while the 5-year overall survival (OS) was 67.5% ± 1.6% for B-cell ALL and 54.3% ± 0.6% for T-cell ALL. The 5-year cumulative incidence of central nervous system (CNS) relapse was 5.5% ± 0.6%. For the whole cohort, significantly higher outcomes were seen for patients aged 1–10 years, with DNA index &gt;0.9, with hyperdiploid ALL, and without substantial treatment modifications. In multivariable analyses, age and Day 15 MRD continued to have a significant effect on EFS.ConclusionOutcomes in this multi-institutional cohort describe poor outcomes, influenced by incomplete and inconsistent risk stratification, early toxic death, high on-treatment mortality, and high CNS relapse rate. Adopting comprehensive risk-stratification strategies, evidence-informed de-intensification for favorable-risk patients and optimized supportive care could improve outcomes