Propuesta de implementación de un sistema de seguridad en el manejo Integral de residuos sólidos en la curtiembre Gonzalo Lino Sotomayor Alpaca en Arequipa 2019

Las industrias de curtiembres hoy en día no vienen realizando un adecuado manejo de residuos sólidos. Para la obtención del cuero se utilizan diferentes insumos químicos, unos más letales que otros dependiendo de la cantidad a usar los cuales atentan contra la salud de los trabajadores y al mismo tiempo generan problemas de contaminación. En ese sentido, el presente trabajo pretende contribuir a reducir el índice de enfermedades profesionales implementando un Sistema de Seguridad en el Manejo Integral de Residuos Sólidos, el cual nos permitirá gestionar de manera eficaz los residuos provenientes de cada etapa de la curtiembre y al mismo tiempo promover una cultura preventiva para salvaguardar la salud y seguridad de los trabajadores y disminuir las consecuencias que se puedan generar debido a la utilización y manipulación de sustancias químicas. La metodología aplicada en el presente documento consiste en realizar un diagnóstico a la empresa a fin de conocer el estado actual de la empresa con respecto a la gestión que ellos vienen realizando en el manejo de residuos sólidos y a partir de los resultados encontrados implementar las medidas preventivas. El Sistema de Seguridad en el Manejo Integral de R.R.S.S. nos permitirá garantizar la seguridad de las personas. Como caso de estudio consideramos la curtiembre Gonzalo Lino Sotomayor Alpaca, en las diferentes actividades que desarrolla para la obtención del cuero. Como contribuciones de la presente investigación se diseñó la Lista de Verificación, utilizado para realizar un diagnóstico inicial de la empresa sobre el manejo de R.R.S.S. y un Sistema de Seguridad compuesto por una matriz IPERC, plan de manejo de residuos sólidos el cual debe incluir capacitación y procedimientos seguros. Para la implementación del Sistema de Seguridad en el Manejo Integral de residuos sólidos se realizó la evaluación inicial en la curtiembre, mediante la aplicación de la lista de verificación y un examen a los trabajadores. Luego se identificó y analizó las sustancias químicas que intervienen en cada etapa del proceso y los residuos que se derivan. Mediante la matriz IPERC se identificaron los peligros y riesgos y se establecieron medidas de control. Debido a que la empresa no cuenta con un plan de manejo integral se vio por conveniente elaborarlo adicionando medidas de control en la gestión de residuos.Trabajo de investigaciónCampus Arequip

The impact of glucocorticoids and anti-cd20 therapy on cervical human papillomavirus infection risk in women with systemic lupus erythematosus

OBJECTIVE: To identify the prevalence and factors associated with cervical human papillomavirus infection in women with systemic lupus erythematosus METHODS: This cross-sectional study collected traditional and systemic lupus erythematosus-related disease risk factors, including conventional and biologic therapies. A gynecological evaluation and cervical cytology screen were performed. Human papillomavirus detection and genotyping were undertaken by PCR and linear array assay. RESULTS: A total of 148 patients were included, with a mean age and disease duration of 42.5±11.8 years and 9.7±5.3 years, respectively. The prevalence of squamous intraepithelial lesions was 6.8%. The prevalence of human papillomavirus infection was 29%, with human papillomavirus subtype 59 being the most frequent. Patients with human papillomavirus were younger than those without the infection (38.2±11.2 vs. 44.2±11.5 years, respectively; p = 0.05), and patients with the virus had higher daily prednisone doses (12.8±6.8 vs. 9.7±6.7 mg, respectively; p = 0.01) and cumulative glucocorticoid doses (14.2±9.8 vs. 9.7±7.3 g, respectively; p = 0.005) compared with patients without. Patients with human papillomavirus infection more frequently received rituximab than those without (20.9% vs. 8.5%, respectively; p = 0.03). In the multivariate analysis, only the cumulative glucocorticoid dose was associated with human papillomavirus infection. CONCLUSIONS: The cumulative glucocorticoid dose may increase the risk of human papillomavirus infection. Although rituximab administration was more frequent in patients with human papillomavirus infection, no association was found. Screening for human papillomavirus infection is recommended in women with systemic lupus erythematosus

Plan de actividades para potenciar el desarrollo personal, cognitivo, social y cultural de los niños del CAEF – Campiña de Moche- Trujillo – Perú

RESUMEN El presente artículo ha sido realizado con el objetivo de potenciar el desarrollo tanto personal, cognitivo, social y cultural de los niños del Centro de Atención y Educación a la Familia (CAEF) a través de la ejecución de distintas actividades. Estas se han llevado acabo de manera práctica y metodológica, a través de la recopilación e investigación de los temas antes de su realización, a manera de talleres, con los niños durante todas las semanas. Todos los talleres han sido organizados en un plan de acción, el cual fue enviado a la dirección del CAEF con el fin de su respectiva aprobación. Para determinar los temas a tratar en cada taller, se analizó junto con la directora la situación del albergue. Asimismo, la necesidad de enfocarse en temas concretos como la autoestima, los valores, reforzamiento cognitivo, social, cultural y físico. Los resultados obtenidos luego de 10 semanas de la continua aplicación de talleres fueron una mejora en el comportamiento de los niños del albergue para con el equipo ejecutor, asimismo el reforzamiento de competencias y la formación de una visión a futuro de ellos mismos. En conclusión, el presente plan de implementación de actividades contribuyó en el desarrollo de cada niño tanto en el aspecto personal, social, cultural como cognitivo.ABSTRACT This paper has been made with the purpose to potentiate the personal, cognitive, social and cultural development of the children from Center of Education and Support for the families, through the execution of different activities. This activities has been made on a practical and methodological way, through a previous research of the different topics, as workshops, with the children from CAEF organization during all weeks. All workshops were organized on an action plan, which was sent to the institution to be approved. To determine the topics to develop with the children every week, we analyzed the situation of the institution with the director of CAEF, Mrs. Judith Villalobos, who helped with the final details of the action plan. Also, the need to focus on specific topics like self-steem, values, cognitive reinforcement, social reinforcement, cultural reinforcement and the physical one. The results after ten weeks of hard work improving the action plan, were a better relationship with the UPN team. Also the new knowledge we shared with children, that allows them to give their opinions to other without be afraid of what will they think about each one and a future vision of themselves been good people and great professionals in the society. In conclusion, the present action plan contributed with the development of children from CAEF through the workshops during the ten weeks

Aguas del Iténez o Guaporé

Bolivia y Brasil comparten una de las cuencas más atractivas y preservadas de la te-giuri amazônica: la cuenca del rio llénez o Guaporé, que escurre tanto sobre el lecho rocoso del Escudo Precámbrico Brasilefto como sobre las Hanuras del Beni. Estas influencias hacen que la cuenca del iténez tenga una elevada heterogeneidad de habitats, una fauna acuálica peculiar y un alto valor de conservation. Este patrimo­nio binacional posée un potencial importante para la conservación de la diversidad regional y cl dcsar rollo sostcniblc participativo de las comunidades locales. El libro contiene un resumen del conotimìento de la cuenca y sus recursos, generado en los últimos 10 anos por un equipo de investigadores bolivianos, brasilefios y de otras nacionalidades. Se presenta una descripeión del medio fisico, así como resultados relevantes sobre la biodiversidad acuática, con énfasis en algas, peces, reptiles y mamíferos. El aporte más notable del libro, adernas de la descripeión ecológica del ecosistema, son las lecciones aprendidas que surgieron de experiências locales sobre la élaboration participativa de herramientas para la gestion de los recursos hidrobiológicos.A Bolívia e o Brasil compartilham uma das bacias hidrográficas mais atrativas e preservadas da região amazônica: a bacia do Rio Iténez ou Guaporé. A combinação das influências do escudo pré-cambriano brasileiro e da planícies do Beni é uma das razões pela qual existem na região elevada heterogeneidade de habitats, fauna aquática peculiar e alto grau valor dc conservação. Eslc patrimônio binacional possui potencial significativo para a conservação da diversidade regional e desenvolvimento sustentável participativo das comunidades locais. O livro contém um resumo do conhecimento da bacia e seus recursos, gerado nos últimos dez anos por uma equipe de pesquisadores bolivianos, brasileiros e de outras nacionalidades. Apresentamos uma descrição do meio físico, bem como resultados relevantes da biodiversidade aquática, com ênfase em algas, peixes, répteis e mamíferos. A contribuição mais notável do livro, além da descrição ecológica do ecossistema, é a descrição das lições aprendidas que surgiram a partir de experiências locais sobre elaboração participativa de ferramentas para a gestão dos recursos aquáticos presentes nesta bacia

estudos artísticos

A revista Gama, Estudos Artísticos estabeleceu-se como um instrumento para a disseminação do conhecimento em torno da arte e da cultura numa perspetiva que se crê inovadora, e que nos caracteriza: estudar arte e artistas através do olhar formado e privilegiado dos companheiros de profissão. Artistas estudam outros artistas. A revista Gama pertence assim a um projeto de resistência: resistência ao centrismo do artworld, ao esmagamento pelos discursos dominantes, às lógicas de reprodução da legitimação instituída. Há uma característica que prevalece em todos os 28 artigos reunidos na presente edição: a reflexão informada sobre autores e obras de arte, que propõe novas leituras e novas redes de conhecimento. Todas juntas constituem um tecido que descobre sentidos, na sua integração global na nova paisagem cultural.info:eu-repo/semantics/publishedVersio

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection