Sistema web de aviso a bomberos con soporte multimedia y georreferencia para dispositivos móviles, Paraguay

La institución de bomberos voluntarios de Paraguay, hoy día cuenta con un sistema de toma de decisión de manera rápida pero imprecisa, ya que las llamadas, la interpretación y la deducción del mensaje del emisor constituyen una fuente importante de errores. Esta situación se puede mejorar ostensiblemente agilizando y precisando la actuación mediante el uso de las tecnologías disponibles en la actualidad. Esto ha generado la idea de desarrollar una aplicación móvil en ambiente web para la logística de operaciones de siniestros de los profesionales bomberos. La evolución de los dispositivos móviles e Internet 4G LTE, donde el envío de datos multimedia es considerablemente más rápido, y la capacidad de la geo-localización, que posibilita obtener la ubicación exacta del lugar de los hechos, hacen que esta aplicación desarrollada sea de una gran ayuda informativa, para la institución de bomberos voluntarios. Con el aplicativo móvil desarrollado, se realizaron pruebas dentro de un cuartel de bomberos, con simulaciones que llevaron a proveer información esencial para una comparativa de los métodos convencional y propuesto, gracias a la cual se pudo comprobar la confiabilidad e integridad de los datos recibidos y el funcionamiento correcto de los mismos en las diferentes situaciones, que contribuyó de manera efectiva en reducir el tiempo de toma de decisión y en el discernimiento más correcto de la situación en los casos de siniestrosFil: Cabrera Paiva, Alexis David. Universidad Nacional del Este (Paraguay)Fil: Lovera Villalba, Antony Carlos. Universidad Nacional del Este (Paraguay)Fil: Dechia, Pablo Javier. Universidad Nacional del Este (Paraguay)Fil: Rojas Pukall, Celso Alberto. Universidad Nacional del Este (Paraguay

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

BackgroundWe previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15-20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in similar to 80% of cases.MethodsWe report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded.ResultsNo gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5-528.7, P=1.1x10(-4)) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR=3.70[95%CI 1.3-8.2], P=2.1x10(-4)). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR=19.65[95%CI 2.1-2635.4], P=3.4x10(-3)), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR=4.40[9%CI 2.3-8.4], P=7.7x10(-8)). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD]=43.3 [20.3] years) than the other patients (56.0 [17.3] years; P=1.68x10(-5)).ConclusionsRare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60 years old