Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 7

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, volumen 7, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, que cuenta con el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. La gestión del conocimiento es un camino para consolidar una plataforma en las empresas públicas o privadas, entidades educativas, organizaciones no gubernamentales, ya sea generando políticas para todas las jerarquías o un modelo de gestión para la administración, donde es fundamental articular el conocimiento, los trabajadores, directivos, el espacio de trabajo, hacia la creación de ambientes propicios para el desarrollo integral de las instituciones

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 10

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 10, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, que cuenta con el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. La gestión del conocimiento es un camino para consolidar una plataforma en las empresas públicas o privadas, entidades educativas, organizaciones no gubernamentales, ya sea generando políticas para todas las jerarquías o un modelo de gestión para la administración, donde es fundamental articular el conocimiento, los trabajadores, directivos, el espacio de trabajo, hacia la creación de ambientes propicios para el desarrollo integral de las instituciones

Potentially useful flora from the tropical rainforest in central Veracruz, Mexico: considerations for their conservation

Tropical rainforests have been a valuable source of resources for human kind. However, this ecosystem is disappearing at an alarming rate, with only isolated fragments remaining in inaccessible zones and showing high probability of disappearing. The aim of this study was to identify tropical rainforest plant species with potential for human use in the central region of Veracruz, Mexico. A floristic inventory was compiled of rainforest fragments and secondary vegetation using the plotting method. The total area sampled was 5600 m². Using the equation Clench model, the proportion of species inventoried was assessed. This was 85% (tq = 0.85) for the rainforest and 90% (tq = 0.9) for the secondary vegetation. A total of 338 species, 210 genera and 89 families were recorded. Using semi-structured interviews with locals, a list of useful plants was drawn up and it was found that people recognized and used 47% of the species inventoried. Additionally, contingency tables and the Spearman correlation test were performed to determine the differences in knowledge and use of the vegetation among villages, as well as in the gender and age group of the respondents. Nevertheless, we found no significant differences (P>0.05). The use value (UV) was calculated to analyze the use of flora. in order to assess the relationship between the UV and their ecological importance, the index of adjusted ecological importance value (AEIV) was obtained. We detected that the most used species are not necessarily those of greater ecological importance. The potentially useful flora was defined based on a literature research, in situ interviews, as well as on their visual and morphological characteristics. According to the data, more than 50% of the inventoried species are potentially useful, mainly as ornamental and medicinal ones, and they provide new economic alternatives for the local people with a minimum impact on the rainforest.Las selvas tropicales perennifolias representan una fuente de recursos valiosos para la humanidad. Sin embargo, están desapareciendo a una velocidad alarmante, quedando solo fragmentos aislados localizados en zonas de difícil acceso y próximos a desaparecer. El objetivo de este estudio fue identificar las especies vegetales de la selva mediana perennifolia con características potenciales de uso en la región central del estado de Veracruz, México. Para ello se realizó un levantamiento florístico en fragmentos de selva y vegetación secundaria usando el método de muestreo por cuadros. El área total muestreada fue de 5600 m². Mediante la ecuación del modelo de Clench, se evaluó la proporción de especies inventariadas, la cual fue de 80% (tq = 0.8) para la selva y 90% (tq = 0.9) para la vegetación secundaria. Se registró un total de 338 especies, 210 géneros y 89 familias. A través de entrevistas semiestructuradas, se generó un listado de las plantas útiles y se encontró que la población conoce y usa 47% de estas especies. Se realizaron tablas de contingencia y un análisis de correlación de Spearman para determinar las diferencias entre el conocimiento y uso de la vegetación en las localidades, así como entre el género y el grupo de edad de los entrevistados. Sin embargo, no se hallaron diferencias significativas (P>0.05). Para analizar el uso de la flora, se calculó el valor de uso (UV) y para evaluar la relación entre el valor de uso de las especies y su importancia ecológica, se obtuvo el índice ajustado de valor de importancia ecológica (AEIV). Con ello se detectó que las plantas más usadas no son necesariamente las de mayor importancia ecológica. La flora potencialmente útil fue definida con base en la revisión bibliográfica, las entrevistas y a sus características visuales y morfológicas. De acuerdo con los datos obtenidos, más de 50% de las especies inventariadas poseen este valor, principalmente como ornamentales y medicinales, y proporcionan nuevas alternativas económicas para los pobladores locales con un mínimo de destrucción de la selva tropical

Monotherapy with darunavir/ritonavir is effective and safe in clinical practice

Introduction: Monotherapy against HIV has undoubted theoretical advantages and has good scientific fundaments. However, it is still controversial and here we will analyze the efficacy and safety of MT with darunavir with ritonavir (DRV/r) on patients who have received this treatment in our hospitals. Materials and Methods: Observational retrospective study that includes patients from 10 Andalusian hospitals that have received DRV/r in MT and that have been followed over a minimum of 12 months. We carried out a statistical descriptive analysis based on the profile of patients who had been prescribed MT and the efficacy and safety that were observed, paying special attention to treatment failure and virological evolution. Results: DRV/r was prescribed to 604 patients, of which 41.1% had a CD4 nadir <200/mmc. 33.1% had chronic hepatitis caused by HCV, had received an average of five lines of previous treatment and had a history of treatment failure to analogues in 33%, to non-analogues 22 and protease inhibitors (PI) in 19.5%. 76.6% proceeded from a previous treatment with PI. The simplification was the main criteria for the instauration of MT in the 81.5% and the adverse effects in the 18.5%. We managed to maintain MT in 84% of cases, with only 4.8% of virological failure (VF) with viral load (VL) >200 c/mL and 3.6% additional losses due to VF with VL between 50 and 200 copies/mL. Thirty three genotypes were performed after failure without findings of resistance mutations to DRV/r or other IPs. Only 23.7% of patients presented some blips during the period of exposition to MT. Eighty seven percent of all determinations of VL had <50 copies/mL, and only 4.99% had >200 copies/mL. Although up to 14.9% registered at some point an AE, only 2.6% abandoned MT because of AE and 1.2% because of voluntary decision. Although the average of total and LDL cholesterol increases 10 mg/dL after 2 years of follow-up, so did HDL cholesterol in 3mg/dL and the values of triglycerides (−14 mg/dL) and GPT (−6 UI/mL) decreased. The average count of CD4 lymphocytes increased from 642 to 714/mm3 at 24 weeks. Conclusions: In a very broad series of patients obtained from clinical practice, data from clinical trials was confirmed: MT with DRV as a de-escalation strategy is very safe, it's associated to a negligible rate of adverse effects and maintains a good suppression of HIV replication. VF (with >50 or >200 copies/mL) is always under 10% and in any case without consequences

Monotherapy with darunavir/ritonavir is effective and safe in clinical practice.

Journal Article;INTRODUCTION Monotherapy against HIV has undoubted theoretical advantages and has good scientific fundaments. However, it is still controversial and here we will analyze the efficacy and safety of MT with darunavir with ritonavir (DRV/r) on patients who have received this treatment in our hospitals. MATERIALS AND METHODS Observational retrospective study that includes patients from 10 Andalusian hospitals that have received DRV/r in MT and that have been followed over a minimum of 12 months. We carried out a statistical descriptive analysis based on the profile of patients who had been prescribed MT and the efficacy and safety that were observed, paying special attention to treatment failure and virological evolution. RESULTS DRV/r was prescribed to 604 patients, of which 41.1% had a CD4 nadir 200 c/mL and 3.6% additional losses due to VF with VL between 50 and 200 copies/mL. Thirty three genotypes were performed after failure without findings of resistance mutations to DRV/r or other IPs. Only 23.7% of patients presented some blips during the period of exposition to MT. Eighty seven percent of all determinations of VL had 200 copies/mL. Although up to 14.9% registered at some point an AE, only 2.6% abandoned MT because of AE and 1.2% because of voluntary decision. Although the average of total and LDL cholesterol increases 10 mg/dL after 2 years of follow-up, so did HDL cholesterol in 3mg/dL and the values of triglycerides (-14 mg/dL) and GPT (-6 UI/mL) decreased. The average count of CD4 lymphocytes increased from 642 to 714/mm(3) at 24 weeks. CONCLUSIONS In a very broad series of patients obtained from clinical practice, data from clinical trials was confirmed: MT with DRV as a de-escalation strategy is very safe, it's associated to a negligible rate of adverse effects and maintains a good suppression of HIV replication. VF (with >50 or >200 copies/mL) is always under 10% and in any case without consequences.Ye

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN