Proyecto emprendimiento social. Cupcakes Tentación.

En la localidad San Cristóbal al suroriente de Bogotá, reside un grupo de mujeres cabeza de hogar, que actualmente se encuentran inactivas laboralmente. Su propósito es diseñar un emprendimiento social buscando mitigar las necesidades económicas que padecen en sus núcleos familiares; partiendo de ello se generó la idea de poder ofertar a un grupo de residentes en la ciudad, adultos mayores entre los 60 a 80 años que padecen enfermedades como diabetes y obesidad, un producto novedoso como lo son los cupcakes saludables. La innovación del emprendimiento es lograr cautivar esta población con cupcakes sabor salado como acompañantes en cenas y meriendas y concientizar el mínimo consumo de azúcar, siendo reemplazado por la Stevia edulcorante natural no calórico. El presente trabajo, busca enumerar una a una las etapas del modelo desing thinking aplicado al proyecto de emprendimiento social, estableciendo estrategias de mercadeo que permitan dar a conocer la compra de los cupcakes por parte de los consumidores. Se busca el apoyo en aliados estratégicos que participen en la sostenibilidad de la idea como parte de la satisfacción y cubrimiento de las necesidades del mercado objetivo. Una vez validada la información y definidas las estrategias, se procede a diseñar un estudio de proyección operativa y financiera que describa la viabilidad del proyecto de emprendimiento social para la fabricación de cupcakes “Tentación”.In San Cristobal's Locality, at Bogota's southeast, lives a group of mothers head of household, who are currently out of work. Their purpose is to design a social enterprise looking for relieve the financial needs of their families; as a result, the idea was generated to be able to offer to a group of Bogota's residents, adults from 60 to 80 years old that have medical conditions like diabetes and obesity, a new product that will be the healthy cupcakes. This enterprise innovation is to captivate this population with salty cupcakes that they can consume as an accompaniment to dinners and snack, making aware of minimal consume of sugar, replacing it with Stevia that is a natural sweetener non caloric. This work is looking to enumerate one by one the phases of the desing thinking model, applied to the social enterprise project, establishing marketing strategies that will be enable to release the purchase of cupcakes by consumers. Also, this work is looking for the support of strategic allies that take part of the idea's sustainability as a part of satisfaction and covering of the market target's needs. Once the information will be validated and the strategies will be defined, it will be desing an operative and financial projection research that describes the social enterprise project for the production of cupcakes "Tentation"

Effectiveness of aligner technique in space closure compared to the edgewise technique : systematic literature review

Antecedentes: Los alineadores transparentes son una alternativa altamente estética para la corrección ortodóntica de las maloclusiones, pero al tratarse de su efectividad en el cierre de espacios en comparación con la técnica de ortodoncia de arco de canto, los resultados reportados en la literatura son controversiales. Objetivo: Determinar la efectividad de la técnica de alineadores en el cierre de espacios comparada con la técnica de ortodoncia con arco de canto a partir de una revisión sistemática de la literatura. Método: Búsqueda electrónica y manual en bases de datos. Publicaciones entre enero de 1999 y agosto de 2022, correspondientes a estudios de intervención y estudios observacionales analíticos (cohorte, y casos y controles), sin discriminación de idioma. Evaluación de la calidad metodológica, nivel de evidencia y grado de recomendación de los estudios incluidos, síntesis de resultados en matriz de análisis. Resultados: Ambas técnicas resultaron efectivas en la reducción del espacio en milímetros. El tiempo total de tratamiento fue menor en los pacientes con Invisalign®, en comparación a la técnica ortodóntica de arco de canto; sin embargo, en casos de extracciones, se reportó que el tiempo de tratamiento es 44% mayor con Invisalign®. El tipo de movimiento predominante es el movimiento de inclinación coronal de los dientes adyacentes hacia el espacio edéntulo con arco de canto y la inclinación progresiva de los dientes adyacentes hacia el espacio con alineadores. La tasa de éxito con relación a la eficacia media general del movimiento dental fue del 59%. No hay diferencias significativas en cuanto a los efectos sobre la arquitectura gingival, posterior al cierre de espacios, al comparar ambas técnicas. Como efecto secundario, durante el cierre con ambas técnicas, se presenta la retroinclinación del segmento anterior. La percepción del dolor fue menor con alineadores; durante el primer mes, la percepción de dolor con alineadores fue menor, y desde el mes 2 al 12, el dolor fue mayor. Conclusión: Las publicaciones analizadas en esta revisión, demostraron que el cierre de espacios con alineadores en mm es igual de efectivo como aquel realizado mediante la técnica de arco de canto.Individuos que presentaran dentición permanente, con necesidad de cierre de espacios, mediante la técnica de alineadores o la técnica ortodóntica de arco de cantoBackground: Clear aligners are a highly aesthetic alternative for orthodontic correction of malocclusions. However, when it comes to their effectiveness in space closure compared to the edgewise technique, the results reported in the literature are controversial. Objective: Determine the effectiveness of the aligner technique in space closure compared to the edgewise technique through a systematic literature review. Method: Electronic and manual search in databases using controlled and uncontrolled language. Publications between January 1999 and August 2022, corresponding to intervention studies and analytical observational studies (cohort and case-control), with no language restrictions. The methodological quality, level of evidence, and degree of recommendation of the included studies were evaluated, and the results were synthesized in an analysis matrix. Results: Both techniques were effective in reducing space in millimeters (residual space of 1 mm up to complete closure). The total treatment time was shorter in patients with Invisalign® compared to the edgewise technique. However, in extraction cases, it was reported that treatment time is 44% longer with Invisalign®. Regarding the predominant type of movement in space closure, a coronal tipping into the space with the edgewise technique, while there is a progressively tipping of teeth into spaces in small increments with aligners. The success rate in relation to the overall effectiveness of dental movement was 59%. There is no difference between both groups in terms of gingival effects during space closure. Regarding secondary effects, lingual/palatal crown torque of the anterior segment was highlighted during closure in both techniques. Pain perception was lower with aligners. According to the VAS, during the first month, there was a lower pain perception with aligners, and from months 2 to 12, the pain was higher. Conclusion: The publications analyzed in this review demonstrated that space closure in millimeters with aligners is equally effective as that achieved with edgewise technique.Especialista en OrtodonciaEspecializació

Clinical practice guideline for surgical antimicrobial prophylaxis

La infección del sitio quirúrgico (ISQ) es una de las principales causas de infecciones asociadas a la atención en salud (IAAS), con un impacto significativo en la mortalidad y morbilidad del paciente quirúrgico, así como en los costos asociados a la atención en salud. El adecuado uso de la profilaxis quirúrgica antimicrobiana es un aspecto fundamental en la reducción del riesgo de ISQ, dado que su utilización inapropiada o indiscriminada puede representar un riesgo para los pacientes y contribuir al desarrollo de resistencia a los antimicrobianos, por lo que resulta de importancia generar directrices que permitan orientar el uso adecuado de antimicrobianos en la profilaxis del paciente quirúrgico, con el objetivo de obtener mejores desenlaces clínicos y propender por un uso racional de antibióticos. La presente guía contiene recomendaciones para profilaxis antibiótica de pacientes sometidos a procedimiento quirúrgico, basadas en la evidencia, realizadas mediante el proceso de adaptación de guías de práctica clínica para el contexto colombiano.Q4Pacientes sometidos a Profilaxis quirúrgica antimicrobianaSurgical site infection (SSI) is one of the main causes of healthcare associated infections (HAI), with a significant impact on the mortality and morbidity of the surgi-cal patient, as well as on the costs associated with health care. The adequate use of surgical antimicrobial prophylaxis being a fundamental aspect in reducing the risk of SSI, taking into account that the inappropriate or indiscriminate use of antibiotics in surgical prophylaxis may represent a risk for patients and contribute to the development of antimicrobial resistance, so it is important to generate guidelines that guide the appropriate antimicrobial prophylaxis in the surgical patient, with the aim of obtaining better clinical outcomes and promoting a rational use of antibiotics. This guide contains recommendations for antibiotic prophylaxis in patients undergoing a surgical procedure, based on evidence, carried out through the process of adapting clinical practice guidelines for the Colombian context.https://orcid.org/0000-0002-5392-7083https://orcid.org/0000-0003-2568-4667Revista Nacional - IndexadaCN

Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease : A Multicentre Study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered "exposed". The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2-2.0), urgent surgery (OR: 1.6; 95% CI: 1.2-2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1-1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3-2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97-1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03-2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

Megaproyectos urbanos y productivos. Impactos socio-territoriales

El desarrollo de megaproyectos productivos trae consigo oportunidades para el crecimiento económico, la generación de empleos y el desarrollo regional. No obstante, en la actualidad, los grandes temas como la expansión urbana, el desarrollo industrial, las cementeras, la minería, el uso intensivo del agua y demás recursos naturales, preocupan a las comunidades por los impactos generados y porque en lo general, no consideran la racionalidad y responsabilidad ambiental y social hacia el entorno. En este contexto son diversos los estudios científicos que, en el marco de la política de económica imperante, intentan posicionarse como alternativas a proyectos económicos que confrontan los intereses particulares y comunitarios y que afectan la salud humana y ambiental. Megaproyectos urbanos y productivos. Impactos socio-territoriales, reúne veinticinco textos académicos sobre las afectaciones que éstos emprendimientos tienen para la sociedad y el entorno. Los temas expuestos recogen experiencias en el desarrollo urbano, industrial, turístico, portuario y aeroportuario, entre otros. Así mismo se retoman temas como la ética, la dialéctica, la política y la economía y su relación en el emprendimiento de megaproyectos. La búsqueda de esquemas productivos racionales y responsables con el entorno, que reivindiquen el derecho de las comunidades a un medio ambiente sano, a la preservación del territorio y sus recursos y de las formas de vida tradicionales, son los referentes para la realización del presente libro. Como elemento central se concibe el territorio como contenedor de identidad y vida, siendo preocupación y tema de estudio de la comunidad académica, las organizaciones de la sociedad civil y las redes de activistas organizados.UAEM, CONACyT, se

The Fifteenth Data Release of the Sloan Digital Sky Surveys: First Release of MaNGA-derived Quantities, Data Visualization Tools, and Stellar Library

Twenty years have passed since first light for the Sloan Digital Sky Survey (SDSS). Here, we release data taken by the fourth phase of SDSS (SDSS-IV) across its first three years of operation (2014 July–2017 July). This is the third data release for SDSS-IV, and the 15th from SDSS (Data Release Fifteen; DR15). New data come from MaNGA—we release 4824 data cubes, as well as the first stellar spectra in the MaNGA Stellar Library (MaStar), the first set of survey-supported analysis products (e.g., stellar and gas kinematics, emission-line and other maps) from the MaNGA Data Analysis Pipeline, and a new data visualization and access tool we call "Marvin." The next data release, DR16, will include new data from both APOGEE-2 and eBOSS; those surveys release no new data here, but we document updates and corrections to their data processing pipelines. The release is cumulative; it also includes the most recent reductions and calibrations of all data taken by SDSS since first light. In this paper, we describe the location and format of the data and tools and cite technical references describing how it was obtained and processed. The SDSS website (www.sdss.org) has also been updated, providing links to data downloads, tutorials, and examples of data use. Although SDSS-IV will continue to collect astronomical data until 2020, and will be followed by SDSS-V (2020–2025), we end this paper by describing plans to ensure the sustainability of the SDSS data archive for many years beyond the collection of data

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

The Fifteenth Data Release of the Sloan Digital Sky Surveys: First Release of MaNGA-derived Quantities, Data Visualization Tools, and Stellar Library

Twenty years have passed since first light for the Sloan Digital Sky Survey (SDSS). Here, we release data taken by the fourth phase of SDSS (SDSS-IV) across its first three years of operation (2014 July–2017 July). This is the third data release for SDSS-IV, and the 15th from SDSS (Data Release Fifteen; DR15). New data come from MaNGA—we release 4824 data cubes, as well as the first stellar spectra in the MaNGA Stellar Library (MaStar), the first set of survey-supported analysis products (e.g., stellar and gas kinematics, emission-line and other maps) from the MaNGA Data Analysis Pipeline, and a new data visualization and access tool we call "Marvin." The next data release, DR16, will include new data from both APOGEE-2 and eBOSS; those surveys release no new data here, but we document updates and corrections to their data processing pipelines. The release is cumulative; it also includes the most recent reductions and calibrations of all data taken by SDSS since first light. In this paper, we describe the location and format of the data and tools and cite technical references describing how it was obtained and processed. The SDSS website (www.sdss.org) has also been updated, providing links to data downloads, tutorials, and examples of data use. Although SDSS-IV will continue to collect astronomical data until 2020, and will be followed by SDSS-V (2020–2025), we end this paper by describing plans to ensure the sustainability of the SDSS data archive for many years beyond the collection of data