Proyecto de Investigación y Conservación en el Templo Pintado de Pachacamac

En el año 2017 se iniciaron las excavaciones en el Templo Pintado, el área emplazada en el frontis noroeste abarcó desde el pie de las graderías con pintura mural polícroma hasta el Cementerio Uhle. Estableciéndose dos áreas de intervención, una asociada a la arquitectura monumental, y otra, asociada a los contextos funerarios removidos del cementerio

Impuesto a la renta y la recaudación tributaria del Gobierno Central

La investigación tuvo como principal objetivo determinar la relación entre la recaudación del impuesto a la renta y la recaudación tributaria del gobierno central en los periodos 2017-2022. El diseño de investigación fue descriptico correlacional y el método de investigación fue cuantitativo. Se tuvo como principal fuente de información a la Superintendencia Nacional de Administración Tributaria (SUNAT). Con la información recopilada se realizaron las pruebas de normalidad y correlación de Pearson para las dos variables que fueron: El impuesto a la renta y la recaudación tributaria. En base a los resultados obtenidos se comprobó que ambas variables presentan una relación positiva y significativa. Además, se obtuvo como resultado que la renta de tercera y quinta categoría presentaron una relación positiva y significativa con relación a la recaudación tributaria. Finalmente, se observó que la renta no domiciliada no presenta una relación positiva y significativa con respecto a la recaudación tributaria

Influencia del tiempo de residencia en la reducción de metales por rizofiltración con chryzopogon zizanioides en un efluente minero, Algamarca, 2019

La presente investigación tuvo como objetivo determinar la influencia del tiempo de residencia en la reducción de metales por rizofiltración con Chryzopogon zizanioides en un efluente minero, Algamarca, 2019. La población estuvo constituida por los socavones (nivel 00, 01, 02, 03, 04, 05) del poblado Algamarca (Cajabamba). Se realizó una investigación experimental, la cual consto de un módulo de metacrilato incoloro, en el cual se instaló en 27 litros. de efluente minero, 10 unidades de plantas de Chrisopogon zizanioides, por un periodo de 28 días, con muestreo de cada 7 días. Los resultados relevantes indican que, hubo reducción significativa de las concentraciones iniciales en comparación con las finales de arsénico, cadmio, cromo, cobre, hierro y zinc, el tiempo óptimo de residencia en el modelo hidropónico para la reducción indica que el cromo es el más eficiente con un tiempo de 14 días, el porcentaje de reducción de arsénico 70.00%, cadmio 69.99%, cromo 69.76%, cobre 70.00%, hierro 70.00% y zinc 70.00%. Se concluye que, Existen diferencias entre las concentraciones iniciales y finales de arsénico, cadmio, cromo, cobre, hierro y Zinc; en el efluente minero Algamarca 2019 y, por último, el tiempo óptimo de residencia en el modelo hidropónico para la reducción fue del Cromo 18.1521 (días) y 435.650 (horas).The purpose of this research was to determine the influence of residence time on the reduction of heavy metals by rhizofiltration with Chryzopogon zizanioides in a mining effluent, Algamarca, 2019. The population was constituted by the socavones (level 00, 01, 02, 03, 04, 05) of the town Algamarca (Cajabamba). An Experimental investigation was carried out, which consisted of a module of colorless methacrylate, in which 10 units of Chrisopogon zizanioides plants were installed in 27 litros of mining effluent, for a period of 28 days, with sampling every 7 days. The relevant results indicate that, there was a significant reduction in the initial concentrations compared to the final arsenic, cadmium, chromium, copper, iron and zinc, the optimal residence time in the hydroponic model for reduction indicates that chromium is the most efficient with a time of 14 days, the percentage of reduction of arsenic 70.00%, cadmium 69.99%, chrome 69.76%, copper 70.00%, iron 70.00% and zinc 70.00%. It is concluded that, there are differences between the initial and final concentrations of arsenic, cadmium, chromium, copper, iron and zinc; In the Algamarca mining effluent 2019 and finally, the optimal residence time in the hydroponic model for the reduction was Chrome 18.1521 (days) and 435.650 (hours)

Therapeutic exercise to improve motor function among children with Down Syndrome aged 0 to 3 years: a systematic literature review and meta‑analysis

Los efectos y los parámetros de prescripción del ejercicio terapéutico no están claros. Por ello, es necesario determinar el efecto de los ejercicios terapéuticos sobre la función motora de niños con Síndrome de Down (SD) de 0 a 3 años. El presente estudio es una revisión sistemática y un metanálisis de los resultados de efectividad en esta población: marcha, equilibrio, desarrollo motor, habilidades motoras finas y funciones ejecutivas. Se realizaron búsquedas en las bases de datos de PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane Library desde enero hasta diciembre de 2019. Reclutamos ensayos controlados aleatorios (ECA) que cumplieron con los criterios de inclusión en nuestro estudio. Se incluyeron seis estudios y 151 participantes. Se identificaron dos tipos de ejercicios terapéuticos, aeróbicos y neuromusculares. Ambos tipos de ejercicio fueron efectivos para mejorar los resultados. No hubo diferencias entre los modos de aplicación del ejercicio. No se identificaron diferencias entre la cinta de correr y el plan de fisioterapia para la reducción del tiempo para alcanzar la marcha independiente, Diferencia de Medias (DM) 46,79, Intervalo de Confianza (IC) del 95% (−32,60, 126,19), ni para el aumento de la velocidad de la marcha DM 0,10 IC (− 0,02, 0,21) m/s. Este estudio sugiere que la terapia con ejercicios aeróbicos tiene un papel potencialmente efectivo para promover la marcha y el desarrollo motor de niños con SD de 0 a 3 años cuando se aplica en una cinta rodante con una frecuencia de 5 días, una duración de 6 a 8 min. y una intensidad de entre 0,2 y 0,5 m/s. Se requieren estudios con menor heterogeneidad y tamaños de muestra más grandes. No se identificaron diferencias entre la cinta de correr y el plan de fisioterapia para la reducción del tiempo para alcanzar la marcha independiente, Diferencia de Medias (DM) 46,79, Intervalo de Confianza (IC) del 95% (−32,60, 126,19), ni para el aumento de la velocidad de la marcha DM 0,10 IC (− 0,02, 0,21) m/s. Este estudio sugiere que la terapia con ejercicios aeróbicos tiene un papel potencialmente efectivo para promover la marcha y el desarrollo motor de niños con SD de 0 a 3 años cuando se aplica en una cinta rodante con una frecuencia de 5 días, una duración de 6 a 8 min. y una intensidad de entre 0,2 y 0,5 m/s. Se requieren estudios con menor heterogeneidad y tamaños de muestra más grandes. No se identificaron diferencias entre la cinta de correr y el plan de fisioterapia para la reducción del tiempo para alcanzar la marcha independiente, Diferencia de Medias (DM) 46,79, Intervalo de Confianza (IC) del 95% (−32,60, 126,19), ni para el aumento de la velocidad de la marcha DM 0,10 IC (− 0,02, 0,21) m/s. Este estudio sugiere que la terapia con ejercicios aeróbicos tiene un papel potencialmente efectivo para promover la marcha y el desarrollo motor de niños con SD de 0 a 3 años cuando se aplica en una cinta rodante con una frecuencia de 5 días, una duración de 6 a 8 min. y una intensidad de entre 0,2 y 0,5 m/s. Se requieren estudios con menor heterogeneidad y tamaños de muestra más grandes. Este estudio sugiere que la terapia con ejercicios aeróbicos tiene un papel potencialmente efectivo para promover la marcha y el desarrollo motor de niños con SD de 0 a 3 años cuando se aplica en una cinta rodante con una frecuencia de 5 días, una duración de 6 a 8 min. y una intensidad de entre 0,2 y 0,5 m/s. Se requieren estudios con menor heterogeneidad y tamaños de muestra más grandes. Este estudio sugiere que la terapia con ejercicios aeróbicos tiene un papel potencialmente efectivo para promover la marcha y el desarrollo motor de niños con SD de 0 a 3 años cuando se aplica en una cinta rodante con una frecuencia de 5 días, una duración de 6 a 8 min. y una intensidad de entre 0,2 y 0,5 m/s. Se requieren estudios con menor heterogeneidad y tamaños de muestra más grandes.Q1The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of therapeutic exercises on the motor function of children with Down Syndrome (DS) aged 0 to 3 years. The present study is systematic review and meta-analysis of effectiveness outcomes in this population: gait, balance, motor development, fine motor skills, and executive functions. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from January to December 2019. We recruited Randomized Controlled Trials (RCTs) which met the inclusion criteria in our study. Six studies and 151 participants were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. Both types of exercise were effective in improving outcomes. There were no differences between the modes of application of the exercise. No differences were identified between the treadmill and the physiotherapy plan for the reduction of the time to reach independent walking, Mean Difference (MD) 46.79, 95% Confidence Interval (IC) (− 32.60, 126.19), nor for the increase in walking speed MD 0.10 IC (− 0.02, 0.21) m/s. This study suggests that aerobic exercise therapy has a potentially effective role to promote the gait and motor development of children with DS aged 0 to 3 years when it is applied using a treadmill with a frequency of 5 days, a duration of 6–8 min, and an intensity of between 0.2 and 0.5 m/s. Studies with less heterogeneity and larger sample sizes are required.Revista Internacional - IndexadaS

Obstructive Sleep Apnoea Syndrome, Endothelial Function and Markers of Endothelialization. Changes after CPAP

Study objectives This study tries to assess the endothelial function in vivo using flow-mediated dilatation (FMD) and several biomarkers of endothelium formation/restoration and damage in patients with obstructive sleep apnoea (OSA) syndrome at baseline and after three months with CPAP therapy. Design Observational study, before and after CPAP therapy. Setting and Patients We studied 30 patients with apnoea/hypopnoea index (AHI) > 15/h that were compared with themselves after three months of CPAP therapy. FMD was assessed non-invasively in vivo using the Laser-Doppler flowmetry. Circulating cell-free DNA (cf-DNA) and microparticles (MPs) were measured as markers of endothelial damage and the vascular endothelial growth factor (VEGF) was determined as a marker of endothelial restoration process. Measurements and results After three month with CPAP, FMD significantly increased (1072.26 +/- 483.21 vs. 1604.38 +/- 915.69 PU, p<0.005) cf-DNA and MPs significantly decreased (187.93 +/- 115.81 vs. 121.28 +/- 78.98 pg/ml, p<0.01, and 69.60 +/- 62.60 vs. 39.82 +/- 22.14 U/mu L, p<0.05, respectively) and VEGF levels increased (585.02 +/- 246.06 vs. 641.11 +/- 212.69 pg/ml, p<0.05). These changes were higher in patients with more severe disease. There was a relationship between markers of damage (r = -0.53, p< 0.005) but not between markers of damage and restoration, thus suggesting that both types of markers should be measured together. Conclusions CPAP therapy improves FMD. This improvement may be related to an increase of endothelial restoration process and a decrease of endothelial damage

LipoDDx: a mobile application for identification of rare lipodystrophy syndromes

BACKGROUND: Lipodystrophy syndromes are a group of disorders characterized by a loss of adipose tissue once other situations of nutritional deprivation or exacerbated catabolism have been ruled out. With the exception of the HIV-associated lipodystrophy, they have a very low prevalence, which together with their large phenotypic heterogeneity makes their identification difficult, even for endocrinologists and pediatricians. This leads to significant delays in diagnosis or even to misdiagnosis. Our group has developed an algorithm that identifies the more than 40 rare lipodystrophy subtypes described to date. This algorithm has been implemented in a free mobile application, LipoDDx(R). Our aim was to establish the effectiveness of LipoDDx(R). Forty clinical records of patients with a diagnosis of certainty of most lipodystrophy subtypes were analyzed, including subjects without lipodystrophy. The medical records, blinded for diagnosis, were evaluated by 13 physicians, 1 biochemist and 1 dentist. Each evaluator first gave his/her results based on his/her own criteria. Then, a second diagnosis was given using LipoDDx(R). The results were analysed based on a score table according to the complexity of each case and the prevalence of the disease. RESULTS: LipoDDx(R) provides a user-friendly environment, based on usually dichotomous questions or choice of clinical signs from drop-down menus. The final result provided by this app for a particular case can be a low/high probability of suffering a particular lipodystrophy subtype. Without using LipoDDx(R) the success rate was 17 +/- 20%, while with LipoDDx(R) the success rate was 79 +/- 20% (p < 0.01). CONCLUSIONS: LipoDDx(R) is a free app that enables the identification of subtypes of rare lipodystrophies, which in this small cohort has around 80% effectiveness, which will be of help to doctors who are not experts in this field. However, it will be necessary to analyze more cases in order to obtain a more accurate efficiency value

Chromatin regulation by Histone H4 acetylation at Lysine 16 during cell death and differentiation in the myeloid compartment

Histone H4 acetylation at Lysine 16 (H4K16ac) is a key epigenetic mark involved in gene regulation, DNA repair and chromatin remodeling, and though it is known to be essential for embryonic development, its role during adult life is still poorly understood. Here we show that this lysine is massively hyperacetylated in peripheral neutrophils. Genome-wide mapping of H4K16ac in terminally differentiated blood cells, along with functional experiments, supported a role for this histone post-translational modification in the regulation of cell differentiation and apoptosis in the hematopoietic system. Furthermore, in neutrophils, H4K16ac was enriched at specific DNA repeats. These DNA regions presented an accessible chromatin conformation and were associated with the cleavage sites that generate the 50 kb DNA fragments during the first stages of programmed cell death. Our results thus suggest that H4K16ac plays a dual role in myeloid cells as it not only regulates differentiation and apoptosis, but it also exhibits a non-canonical structural role in poising chromatin for cleavage at an early stage of neutrophil cell death

Should we suspect primary aldosteronism in patients with hypokalaemic rhabdomyolysis? A systematic review

Severe hypokalaemia causing rhabdomyolysis (RML) in primary aldosteronism (PA) is a rare entity, and only a few cases have been reported over the last four decades. This systematic review and case report aims to gather all published data regarding a hypokalaemic RML as presentation of PA in order to contribute to the early diagnosis of this extremely rare presentation. With the use of PubMed Central, EMBASE, and Google Scholar, a thorough internet-based search of the literature was conducted to identify articles and cases with RML secondary to hypokalaemia due to PA between June 1976 and July 2023. The case study concerns a 68-year-old male patient with hypokalaemic RML at presentation of PA. In the systematic review of the literature, 37 cases of RML secondary to hypokalaemia due to PA have been reported to date. In summary, the median age was 47.5 years, the male/female ratio was 17/21, all patients presented symptoms (weakness and/or myalgia), all the patients were hypertensive, and only four patients had complications with acute kidney injury (AKI). Although PA rarely presents with RML, it should be suspected when marked hypokalaemia and hypertension are also present. Early detection and management are essential to reduce the frequency of manifestations such as AKI

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat