Comportamiento clínico-epidemiológico del embarazo en adolescentes de 15 a 19 años atentidas en el Hospital Amistad México-Nicaragua del Municipio de Ticuantepe, Managua. 2019

Objetivo: Evaluar el comportamiento clínico-epidemiológico del embarazo en adolescentes de 15 a 19 años que asistieron al programa de control prenatal (CPN), del Hospital Amistad México-Nicaragua del Municipio de Ticuantepe, Managua, en el período del 1º de enero al 31 de Diciembre de 2019. Metodología: Con un estudio de tipo cuantitativo, observacional, descriptivo de corte transversal, con una muestra de 86 adolescentes embarazadas que asistieron al programa de control prenatal (CPN), del Hospital Amistad México-Nicaragua del Municipio de Ticuantepe, Managua, en el peródo del 1C de Enero al 31 de Diciembre de 2019. Resultados: El 63.9% tenían de 18 a 19 años. Escolaridad secundaria en el 74.4. En "Unión LIbre" en un 58.1% . Religión Católoca con el 64.0% de la muestra, teniendo una procedencia rural del 7607%. Un 58.1% iniciaron relaciones sexuales entre los 14 y 16 años. Un 74.4% de las adolescentes no tenían embarazo previo, en el 81.4% de las adolescentes embarazadas habían sostenido relaciones sexuales solamente en 1 pareja. El 74.4% de las adolescentes no usaban métodos anticonceptivos. El 75.5% fueron captadas en el programa de CPN antes de las 12 semanas de gestación, y dentro de este grupo, la mayoría (44.2% se le realicó un número de 4 controles prenatales. En el 60.5% las adolescentes embarazadas no tuvieron el deseo de ser madres. Coclusiones: La mayoría tenían edades entre 18 a 19 años, escolaridad secundaria, católicas, en unión libre y de procedencia rural. Predominado la edad de menarca entre 12 a 14 años, IVSA de la 14 a 16 años, 1 compañero sexual, nulíparas y No utilizaron métodos anticonceptivos. La La captación de la adolescente al progrma de APN se realizó anes de la semana 12, teniendo 4 controles prenatales, el 39.5% tenía el deseo de continuar con su embarazo. Palabras claves: (Embarazo Adolescente-Control Prenatal

Variation of structural and hyperfine parameters of (Fe0.70Al0.30) 1-xNbx , with x=0, 0.05, 0.10 and 0.20 System

Fe0.70Al0.30 alloy is a bcc and ferromagnetic phase, being the Al atoms magnetic dilutor. In this work, we study the effect of the Nb on the structural and hyperfine behavior of the Fe0.70Al0.30 alloy when atoms of Nb substitute atoms of Fe or Al. The nanostructured system of (Fe0.70Al0.30)1-xNbx (x = 0, 0.05, 0.10, 0.20, at. %) was obtained by alloying Fe, Al and Nb powders in a planetary ball mill during 12 h, 24 h and 36 h, and a ball mass to powder mass relation of 10:1. The magnetic and hyperfine properties of the samples were studied by X-ray diffraction (XRD) and Mössbauer Spectrometry (MS) at room temperature, respectively. The X-ray diffraction patterns for x=0 showed the bcc-α FeAl structure and its lattice parameter is approximately constant with milling times (∼ 2.91 Å). For x=0.05, 0.10 and 0.20 the patterns showed the coexistence of the α-FeAl, Nb(Fe,Al)2 structural phases with an amorphous component. The Mössbauer spectra of x=0 samples were fitted using hyperfine magnetic field distributions (HMFDs), and the obtained mean hyperfine fields (MHF) were 23.4, 24.2, and 24.3 T for 12, 24, and 36 h of milling time, respectively, which correspond to the α-FeAl structure. The spectra of the samples with x=0.05 and 0.10 were fitted using a model with two components, the first one is a HMFD attributed to the bcc-FeAlNb structure and the second with two doublets attributed to the Nb(Fe,Al)2 structure. When atomic percentage of Nb increases up to 20 at. % the ferromagnetic behavior is diluted due to substitution of Fe-atoms by Nb and Al atoms in the bcc-FeAlNb structure. The magnetic behavior becomes paramagnetic at x=0.20, the spectra were fitted with three doublets, one of them related with bcc-FeAlNb structure and the others to the Nb(Fe,Al)2 structural phase. The alloying of Nb to the Fe0.70Al0.30 system destroyed the magnetism due the substitution of Fe by Nb atoms and generates an amorphization into the syste

Fe-ZnO nanoestructurado obtenido por aleamiento mecánico y sol-gel.

El planteamiento principal de este proyecto era el de encontrar la forma más idónea para preparar el semiconductor magnético ZnO dopado con Fe sin la presencia de fases impuras. El proyecto se propuso de tal forma que se hacían diferentes formas de preparar las muestras y estudiarlas experimentalmente. Las tres formas que se optó para preparar las muestras fueron: A. La primera por aleamiento mecánico entre polvos puros de Fe y ZnO; dopando el ZnO con un 10% de Fe. En el aleamiento mecánico existe un parámetro importante que es la relación entre el peso de las bolas con el peso de la muestra (BPR por sus siglas en Inglés). Se encontró que al aumentar esta relación se logra que todo el Fe penetre dentro de la matriz de ZnO, evitando las fases impuras. Como resultado se logra proponer un modelo fenomenológico de polarones para explicar el mecanismo de magnetización en este modelo. B. La segunda forma de preparar el sistema fue: Alear el ZnO con un 10% de magnetita (Fe3O4). En este caso además de la fase pura de ZnO se obtuvo la fase Fe2O4Zn1 conocida como Franklinite. Entonces existen fases impuras. C. La tercera forma de preparar el sistema: A través de la técnica conocida como sol gel; se prepararon cambiando la concentración del dopante, las muestras obtenidas se estudiaron (as cash) y además se depositaron sobre cristales simples de Si. Lo importante de estas muestras fueron las medidas de reflactancia y la caracterización eléctrica, mostrando un comportamiento semiconductor

Los desafíos del cambio : investigación en diseño

1 archivo PDF (194 páginas)Aborda los desafíos del cambio y la investigación en diseño - a 30 años de distancia de la creación de la Universidad Autónoma Metropolitana y de ejercer la figura de profesor investigador, signo distintivo de nuestra Institución -trata los cambios y desafíos que se han presentado durante este tiempo, con relación a su objeto de estudio, la manera como se concibe y realiza la investigación, como en la práctica se ha dado - o no- el binomio investigación docencia y cómo se enfrentan las dificultades y las soluciones que han tomado los profesores-investigadores

Prognostic models for mortality after cardiac surgery in patients with infective endocarditis: a systematic review and aggregation of prediction models.

Background There are several prognostic models to estimate the risk of mortality after surgery for active infective endocarditis (IE). However, these models incorporate different predictors and their performance is uncertain. Objective We systematically reviewed and critically appraised all available prediction models of postoperative mortality in patients undergoing surgery for IE, and aggregated them into a meta-model. Data sources We searched Medline and EMBASE databases from inception to June 2020. Study eligibility criteria We included studies that developed or updated a prognostic model of postoperative mortality in patient with IE. Methods We assessed the risk of bias of the models using PROBAST (Prediction model Risk Of Bias ASsessment Tool) and we aggregated them into an aggregate meta-model based on stacked regressions and optimized it for a nationwide registry of IE patients. The meta-model performance was assessed using bootstrap validation methods and adjusted for optimism. Results We identified 11 prognostic models for postoperative mortality. Eight models had a high risk of bias. The meta-model included weighted predictors from the remaining three models (EndoSCORE, specific ES-I and specific ES-II), which were not rated as high risk of bias and provided full model equations. Additionally, two variables (age and infectious agent) that had been modelled differently across studies, were estimated based on the nationwide registry. The performance of the meta-model was better than the original three models, with the corresponding performance measures: C-statistics 0.79 (95% CI 0.76–0.82), calibration slope 0.98 (95% CI 0.86–1.13) and calibration-in-the-large –0.05 (95% CI –0.20 to 0.11). Conclusions The meta-model outperformed published models and showed a robust predictive capacity for predicting the individualized risk of postoperative mortality in patients with IE. Protocol registration PROSPERO (registration number CRD42020192602).pre-print270 K

La zona patrimonial de la Cuenca Minera de Riotinto-Nerva: trayectoria y retos patrimoniales de futuro

Este estudio pretende analizar la trayectoria de la Zona Patrimonial, como figura de reciente creación y reducida aplicación a través del caso de la Cuenca Minera de Riotinto-Nerva. La singularidad tanto paisajística como jurídica de este Bien de Interés Cultural hacen de su estudio una oportunidad para avanzar en futuras declaraciones. La evolución del panorama legislativo patrimonial, incluyendo esta novedosa figura de protección plantea la necesidad de evaluar su resultado en términos de gestión patrimonial. En la concurrencia de una serie de agentes patrimoniales y con la convivencia de diferentes normativas y declaraciones previas, se estima necesario analizar la pluralidad de acciones que plantea la administración, incluyendo aspectos fundamentales como la gestión, la evolución en la percepción de los diferentes elementos patrimoniales, su valorización social o las estrategias de difusión aplicadas desde su inscripción. La Cuenca Minera de Riotinto-Nerva constituye uno de los enclaves mineros más antiguos y representativos a nivel mundial. Complementariamente se propone ahondar en las directrices necesarias para su inscripción en la Lista de Patrimonio Mundial, justificándose también su carácter excepcional desde su particularidad cromática, hecho diferencial toponímico e hito identitario para la comunidad local. Se indagará en la definición de sus Valores Universales Excepcionales (VUE) potenciales, sus atributos y posibles límites.This study aims to analyse the trajectory of the Heritage Zone, as a recently created and reduced application figure through the case of the Riotinto-Nerva Mining Basin. The unique landscape and legal characteristics of this Asset of Cultural Interest make this study an opportunity to advance in future statements. The evolution of the legislative panorama of heritage, including this novel preservation figure, raises the need to evaluate its result in terms of heritage management. In the concurrence of a series of heritage agents and with the coexistence of different regulations and previous inscriptions, it is considered necessary to analyse the plurality of actions proposed by the administration, including fundamental aspects such as management, the evolution in the perception of the different heritage elements, their social appreciation or the dissemination strategies applied since their registration. The Riotinto-Nerva Mining Basin is one of the oldest and most representative mining sites in the world. It is also proposed that the guidelines necessary for its inscription on the World Heritage List be further developed, justifying its exceptional character by its colouring, toponymic differentiation and identity landmark for the local community. The definition of its potential Outstanding Universal Values (OUV), their attributes and possible limits will be investigated

Programa SALUD 5-10: Programa para el tratamiento del sobrepeso y la obesidad en niños de 5 a 10 años: Antecedentes, Diseño y Metodología

Obesity is a particularly expensive and costly in economic and social terms disease for both people who suffer as public health institutions. Therefore, in recent decades, various international and national organizations have shown great concern for its implications, going to be treated as a real social problem. According to the World Health Organization, Spain is one of the EU countries with the highest prevalence of overweight children as recorded by 33% in the population between 5 and 17 years, whereas in Europe one in four children has overweight or obese. Furthermore, Spain is one of the countries where this disease has grown (in the eighties the prevalence was 15%). Several systematic reviews assessing the effectiveness of intervention programs based on increasing physical activity and dietary control of overweight and / or obesity in children and adolescents highlight the need to design specific programs for schoolchildren, and to assess objectively the effectiveness of such long-term programs in children and adolescents are overweight or obese. The aim of this paper is to describe the design and methodology used in 5-10 Health Program, a program that has been designed with the objective of addressing overweight and obesity in schoolchildren in the age group between 5-10 years.La obesidad es una enfermedad especialmente cara y costosa en términos económicos y sociales tanto para las personas que la padecen como para las instituciones públicas sanitarias. Por ello, en las últimas décadas distintas organizaciones internacionales y nacionales han mostrado una enorme preocupación por sus implicaciones, pasando a ser tratado como un verdadero problema social. Según la Organización Mundial de la Salud, España es uno de los países de la Unión Europea con mayor prevalencia de sobrepeso infantil, ya que registra un 33% en la población entre 5 y 17 años, mientras que en Europa uno de cada cuatro niños tiene sobrepeso o es obeso. Además, España es uno de los países donde más ha crecido esta enfermedad (en la década de los ochenta la prevalencia era de un 15%). Diversas revisiones sistemáticas que evalúan la efectividad de los programas de intervención basados en el aumento de la actividad física y el control dietético sobre el sobrepeso y/u obesidad en población infantil y adolescente resaltan la necesidad de diseñar programas específicos para los escolares, así como valorar objetivamente la eficacia de dichos programas a largo plazo en niños y adolescentes con sobrepeso u obesidad. El objetivo del presente trabajo es describir el diseño y metodología utilizada en el Programa SALUD 5-10, un programa que ha sido diseñado con el objetivo de abordar el sobrepeso y la obesidad en escolares de una franja de edad entre 5 a 10 años

Minimum detectable and minimal clinically important changes for pain in patients with nonspecific neck pain

<p>Abstract</p> <p>Background</p> <p>The minimal detectable change (MDC) and the minimal clinically important changes (MCIC) have been explored for nonspecific low back pain patients and are similar across different cultural settings. No data on MDC and MCIC for pain severity are available for neck pain patients. The objectives of this study were to estimate MDC and MCIC for pain severity in subacute and chronic neck pain (NP) patients, to assess if MDC and MCIC values are influenced by baseline values and to explore if they are different in the subset of patients reporting referred pain, and in subacute versus chronic patients.</p> <p>Methods</p> <p>Subacute and chronic patients treated in routine clinical practice of the Spanish National Health Service for neck pain, with or without pain referred to the arm, and a pain severity ≥ 3 points on a pain intensity number rating scale (PI-NRS), were included in this study. Patients' own "global perceived effect" over a 3 month period was used as the external criterion. The minimal detectable change (MDC) was estimated by means of the standard error of measurement in patients who self-assess as unchanged. MCIC were estimated by the mean value of change score in patients who self-assess as improved (mean change score, MCS), and by the optimal cutoff point in receiver operating characteristics curves (ROC). The effect on MDC and MCIC of initial scores, duration of pain, and existence of referred pain were assessed.</p> <p>Results</p> <p>658 patients were included, 487 of them with referred pain. MDC was 4.0 PI-NRS points for neck pain in the entire sample, 4.2 for neck pain in patients who also had referred pain, and 6.2 for referred pain. MCS was 4.1 and ROC was 1.5 for referred and for neck pain, both in the entire sample and in patients who also complained of referred pain. ROC was lower (0.5 PI-NRS points) for subacute than for chronic patients (1.5 points). MCS was higher for patients with more intense baseline pain, ranging from 2.4 to 4.9 PI-NRS for neck pain and from 2.4 to 5.3 for referred pain.</p> <p>Conclusion</p> <p>In general, improvements ≤ 1.5 PI-NRS points could be seen as irrelevant. Above that value, the cutoff point for clinical relevance depends on the methods used to estimate MCIC and on the patient's baseline severity of pain. MDC and MCIC values in neck pain patients are similar to those for low back pain and other painful conditions.</p

The Fourteenth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the extended Baryon Oscillation Spectroscopic Survey and from the second phase of the Apache Point Observatory Galactic Evolution Experiment

The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) has been in operation since July 2014. This paper describes the second data release from this phase, and the fourteenth from SDSS overall (making this, Data Release Fourteen or DR14). This release makes public data taken by SDSS-IV in its first two years of operation (July 2014-2016). Like all previous SDSS releases, DR14 is cumulative, including the most recent reductions and calibrations of all data taken by SDSS since the first phase began operations in 2000. New in DR14 is the first public release of data from the extended Baryon Oscillation Spectroscopic Survey (eBOSS); the first data from the second phase of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE-2), including stellar parameter estimates from an innovative data driven machine learning algorithm known as "The Cannon"; and almost twice as many data cubes from the Mapping Nearby Galaxies at APO (MaNGA) survey as were in the previous release (N = 2812 in total). This paper describes the location and format of the publicly available data from SDSS-IV surveys. We provide references to the important technical papers describing how these data have been taken (both targeting and observation details) and processed for scientific use. The SDSS website (www.sdss.org) has been updated for this release, and provides links to data downloads, as well as tutorials and examples of data use. SDSS-IV is planning to continue to collect astronomical data until 2020, and will be followed by SDSS-V.Comment: SDSS-IV collaboration alphabetical author data release paper. DR14 happened on 31st July 2017. 19 pages, 5 figures. Accepted by ApJS on 28th Nov 2017 (this is the "post-print" and "post-proofs" version; minor corrections only from v1, and most of errors found in proofs corrected

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