Creación de la “Marca Ciudad Cascas” para incentivar el turismo interno en el distrito de Cascas, provincia de Gran Chimú 2015

La presente tesis tiene como propósito proponer la “creación de la Marca Cascas para incentivar el turismo interno en el Distrito de Cascas Provincia de Gran Chimú 2015”. Así como el determinar un flujo de turistas nacionales y extranjeros dentro del periodo 2012-2014 y; una eventual proyección del mismo. Luego se elabora un inventario de recursos turísticos de la Ciudad de Cascas, para determinar la identidad e imagen de la marca Ciudad de Cascas. Posteriormente defino la plataforma mediática con la finalidad de difundir los atractivos turísticos de dicho distrito, con el inventario de bienes turísticos. De este modo se propone la puesta en valor sus atractivos turísticos, coadyuvando de esta manera el desarrollo de la industria del turismo, el desarrollo de la infraestructura hotelera y redunde en una mejor calidad de vida para sus pobladores. La metodología utilizada en el desarrollo de la presente investigación ha sido el Método de Análisis y el Método de Síntesis. Finalmente el resultado final de la presente investigación arroja que el concepto de marca Ciudad contribuye al incremento del turismo a la Ciudad de Cascas. El trabajo en mención es novedoso y único en su género, pues no existen investigaciones de este tipo y, sirve de base para futuros estudios en la Ciudad de Cascas.This thesis aims to propose the "branding Cascas to encourage domestic tourism in the District of Cascas province Gran Chimú 2015". As well as determining a flow of domestic tourists and foreigners within the period 2012-2014 and; a possible projection of the same. Then prepares an inventory of tourism resources of the city of Cascas, to determine the identity and image of the brand city of Cascas. Then I define the media platform in order to promote the tourist attractions in the district, with the inventory of tourist goods. Thus proposes the enhancement its tourist attractions, contributing in this way the development of the industry of tourism, the development of the hotel infrastructure and result in a better quality of life for its inhabitants. The methodology used in the development of the present investigation has been the Method of Analysis and the Method of Synthesis. The work in mention is novel and unique in its kind, because there are no investigations of this type, and will form the basis for future studies in the city of CascasTesi

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Trazados de caldereria. Calculo, fabricacion y normalizacion de tuberias

345 p

Quivera 2016-1

El trabajo intitulado “La noción de Cuba entre los emigrados cubanos y sus diferencias geográficas” de Katarzyna Dembicz y Ewelina Biczyńska, se enfoca en las diferencias espaciales tomando en consideración el marco del cambio del orden político y económico de Cuba, que ha registrado un continuo éxodo de la población, evidenciado en una presencia migratoria de cubanos dispersos por el mundo, en las negativas tasas migratorias nacionales y en un estancamiento del crecimiento demográfico. Resultados que parten de una encuesta realizada en línea entre los cubanos residentes en el extranjero a fin de recopilar datos y crear un mapa de nociones de Cuba desde una perspectiva migratoria. Por su parte, Ismael Rodríguez Villalobos, Angélica Montaño Armendáriz y Juan Carlos Pérez Concha, en su trabajo “La competitividad como base para la formación de Sistemas Productivos Locales sustentados en las actividades terciarias en Baja California Sur”, identifican las actividades productivas terciarias con potencial para conformar Sistemas Productivos Locales y fortalecer el tejido empresarial de Baja California Sur, así como evaluar la percepción de los empresarios respecto a las principales variables del desarrollo local y su impacto en el desempeño de sus empresas. El estudio corrobora la importancia que registran las actividades de base terciaria en la estructura económica de la entidad relacionadas con la actividad turística. A su vez , Adrián Hernández Cordero, en su trabajo “La cultura como medio de transformación urbana. El Museo Picasso de Barcelona”, analiza la forma en que la cultura es utilizada en los procesos de trasformación urbana, en el que se estudia el caso del barrio del Casc Antic en Barcelona, en el cual la instalación del Museo Picasso se dispuso como elemento de cambio social con la finalidad de revertir el proceso de deterioro social y estructural en el que se encontraba, cuya instalación del museo ha implicado la reconversión de su área de influencia a través de otros recintos culturales, galerías y bares; además, ha atraído una importante cantidad de artistas conformándolo como un barrio artístico. Desde el punto de vista del trabajo “Diagnóstico de la gestión de Residuos Sólidos Urbanos (RSU) en la ciudad de Bacalar, Quintana Roo mediante el enfoque del Nuevo Institucionalismo”, Luis Alberto Rojas Castillo, Juan Roberto Calderón Maya y Norma Angélica Oropeza García pretenden demostrar cómo el enfoque del nuevo institucionalismo es posible implementarlo para diagnosticar y generar estrategias hacia una gestión integral de Residuos Sólidos Urbanos (RSU) en la ciudad de Bacalar, Quintana Roo, que se justifica al tratar un problema multidimensional, como es el inadecuado manejo de los RSU con una repercusión directa en la dimensión social (salud pública), ambiental, económica y urbana. Finalmente, el trabajo “Lineamientos Base para Elaborar un Plan de Gestión Integral de Residuos Sólidos Urbanos en Ixtlahuaca, Estado de México”, de José Manuel Romero Cuero, Juan Roberto Calderón Maya y Ana María Marmolejo Uribe, da a conocer la situación actual del municipio de Ixtlahuaca, Estado de México, en cuanto a la gestión integral de los residuos sólidos urbanos. El problema es que este municipio carece de infraestructura y de herramientas necesarias para desempeñar sus actividades de recolección, transferencia, transporte y disposición final. La solución del problema implica la participación tanto del gobierno como de la sociedad en general, quienes deben contar con información confiable y actualizada que permita conocer las alternativas y las opciones disponibles para reducir el impacto de los residuos al medio ambiente

Tecnología e innovación en educación superior: escenarios pospandemia

: ilustraciones, tablas, gráficos ; 28 cm.En este libro, titulado Tecnología e innovación en educación superior: escenarios pospandemia, se continúa el diálogo con expertos, específicamente en los temas de mayor debate que surgieron a partir del primer confinamiento provocado por el COVID-19, frente al aporte de la tecnología en los proceso de la calidad educativa. Se han identificado los investigadores que trabajan las temáticas de la obra y se les ha invitado a escribir para este libro, por lo que se convierte en aporte de indudable valor para el sector universitario, y se espera que continúe contribuyendo a los debates sobre la educación superior

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe