EVALUACIÓN DE LA VULNERABILIDAD SÍSMICA Y PROPUESTA DE REFORZAMIENTO AL “HOSPITAL REFERENCIAL FERREÑAFE” -PROVINCIA FERREÑAFE - REGIÓN LAMBAYEQUE-2018

Las evaluaciones sísmicas de edificios es un tema que no es tomado con gran relevancia para los profesionales peruanos en la actualidad, aquellos que se encuentran involucrados en el área de diseño estructural, dando prioridad en la elaboración de nuevos proyectos. El “Hospital Referencial Ferreñafe” , siendo una construcción antigua, presenta indicios de ser vulnerable estructuralmente debido al mal proceso constructivo y el escaso conocimiento de la Ingeniería Sismorresistente que se tuvo en el momento de ejecutar el proyecto, es por ello que el presente estudio dará a conocer si los módulos del “Hospital Referencial Ferreñafe” eran vulnerables sísmicamente ante un acontecimiento sísmico severo, evaluando cada una de ellas a través de un estudio preliminar por el método Hirosawa, siendo un método particularmente para hospitales y un estudio profesional en base al Análisis Dinámico Modal Espectral de la E.030 “Diseño Sismorresistente” del Reglamento Nacional de Edificaciones, al darse una respuesta negativa ante está evaluación se propondrá un tipo de reforzamiento a la edificación para que cumpla los parámetros sísmicos que nos indica la norma E.030 “Diseño Sismorresistente” del Reglamento Nacional de Edificaciones conjuntamente consolidado de estudios adicionales como prueba de corazones diamantinos y un estudio de mecánica de suelos, por lo tanto se concluye que las edificaciones son vulnerables estructuralmente ante un acontecimiento sísmico severo.Tesi

Heterogeneities in the Ecoepidemiology of Trypanosoma cruzi Infection in Rural Communities of the Argentinean Chaco

We conducted a cross-sectional survey of Trypanosoma cruzi infection of Triatoma infestans as well as dogs and cats in 327 households from a well-defined rural area in northeastern Argentina to test whether the household distribution of infection differed between local ethnic groups (Tobas and Creoles) and identify risk factors for host infection. Overall prevalence of infection of bugs (27.2%; 95% confidence interval = 25.3–29.3%), dogs (26.0%; 95% confidence interval = 23.3–30.1%), and cats examined (28.7%; 95% confidence interval = 20.2–39.0%) was similar. A multimodel inference approach showed that infection in dogs was associated strongly with the intensity and duration of local exposure to infected bugs and moderately with household ethnic background. Overall, Toba households were at a substantially greater risk of infection than Creole households. The strong heterogeneities in the distribution of bug, dog, and cat infections at household, village, and ethnic group levels may be used for targeted vector and disease control.Fil: Cardinal, Marta Victoria. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Orozco, Maria Marcela. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Enriquez, Gustavo Fabián. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ceballos, Leonardo A.. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; ArgentinaFil: Gaspe, Maria Sol. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Alvarado Otegui, Julián Antonio. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; ArgentinaFil: Gurevitz, Juan Manuel. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Kitron, Uriel. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; ArgentinaFil: Gurtler, Ricardo Esteban. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Eficacia de la vacuna meningocócica de polisacárido capsular del grupo C

Este informe consiste esencialmente en una revisión sistemática de la literatura científica sobre los efectos, intensidad y duración de la respuesta serológica, así como sobre la eficacia, efectividad y seguridad de la vacuna meningocócica de polisacárido capsular del grupo C.Resumen, Abstract, Abstract INAHTA, Presentación, Introducción Etiología, distribución, diagnóstico, Situación actual de la enfermedad meningocócica en España, Portadores, mecanismo de transmisión e inmunidad, Vacuna meningocócica de polisacáridos capsulares purificados de los grupos A y C, Eficacia y seguridad de la vacuna meningocócica de polisacáridos capsulares purificados de los grupos A y C, Método Eficacia, Inicio de efecto protector, Duración, Reacciones adversas Interacciones, Revacunación, Indicaciones de la vacuna, Recomendaciones sobre el uso de la vacuna meningocócica de polisacárido capsular del grupo C de instituciones y asociaciones profesionales, Resumen Bibliografía

Efecto del cambio climático en el periodo de crecimiento en Guanajuato

El incremento de la temperatura y la modificación de los patrones de distribución de la lluvia son dos de los efectos más ampliamente documentados del cambio climático global. Los impactos que tales cambios están provocando en los procesos de producción agrícola constituyen una de las principales amenazas para la producción de alimentos, sobre todo bajo condiciones de temporal. El presente estudio pretende evidenciar los cambios que han tenido lugar en la disponibilidad de humedad para los cultivos y que son atribuibles al cambio climático en el estado de Guanajuato. El análisis consistió en estimar el periodo de crecimiento por disponibilidad de humedad (PC) a partir de las series históricas diarias de clima de 58 estaciones del Servicio Meteorológico Nacional. Las series históricas se dividieron en dos periodos: el primero de 1960 a 1979 y el segundo de 1980 a 2017. En el periodo de 1960-1979, el inicio del PC, calculado al 80 % de probabilidad acumulativa, ocurrió el día 193 (día juliano), el cual corresponde al 11 de julio; mientras que en el periodo 1980-2017 se presentó hasta el día 211, que corresponde al 30 de julio. En lo que se refiere a la duración del PC, calculada al 80 % de probabilidad de excedencia, se observa una reducción, al pasar de 110 días en el periodo 1960-1979 a solo 75 días en el periodo 1980-2017. De continuar estas tendencias, la superficie agrícola susceptible de ser cultivada bajo condiciones de temporal en el estado se reducirá drásticamente en pocos años

Regulation of Mother-to-Offspring Transmission of mtDNA Heteroplasmy

mtDNA is present in multiple copies in each cell derived from the expansions of those in the oocyte. Heteroplasmy, more than one mtDNA variant, may be generated by mutagenesis, paternal mtDNA leakage, and novel medical technologies aiming to prevent inheritance of mtDNA-linked diseases. Heteroplasmy phenotypic impact remains poorly understood. Mouse studies led to contradictory models of random drift or haplotype selection for mother-tooffspring transmission of mtDNA heteroplasmy. Here, we show that mtDNA heteroplasmy affects embryo metabolism, cell fitness, and induced pluripotent stem cell (iPSC) generation. Thus, genetic and pharmacological interventions affecting oxidative phosphorylation (OXPHOS) modify competition among mtDNA haplotypes during oocyte development and/or at early embryonic stages. We show that heteroplasmy behavior can fall on a spectrum from random drift to strong selection, depending on mito-nuclear interactions and metabolic factors. Understanding heteroplasmy dynamics and its mechanisms provide novel knowledge of a fundamental biological process and enhance our ability to mitigate risks in clinical applications affecting mtDNA transmission.Peer reviewe

Estudio comparativo del tiempo de tránsito intestinal con marcadores radiopacos en pacientes seropositivos y seronegativos para la enfermedad de Chagas

La enfermedad de Chagas afecta el sistema digestivo en un 10 a 15% de los casos. En el período crónico, dentro de los megasíndromes digestivos, el megacolon es más frecuente en Argentina. Este estudio intentó determinar el tiempo de tránsito colorrectal en pacientes seropositivos y seronegativos para la enfermedad de Chagas y así efectuar una comparación entre los mismos y evaluar si existen diferencias significativas. Fueron incluidos pacientes seropositivos y seronegativos para la Enfermedad de Chagas, a los cuales se les realizó examen físico, electrocardiograma, ecocardiograma, RX de tórax y extracción de sangre para realizar diagnóstico serológico actual con Hemaglutinación indirecta, ELISA e Inmunofluorescencia. Para la determinación del tiempo de tránsito colónico se emplearon 24 marcadores radiopacos Sitzmarks administrados y al 5to. día se realizó RX simple de abdomen de pié. Se consideró anormal al encontrarse 5 o más radiomarcadores en la RX

γ-Linolenic acid in maternal milk drives cardiac metabolic maturation.

Birth presents a metabolic challenge to cardiomyocytes as they reshape fuel preference from glucose to fatty acids for postnatal energy production1,2. This adaptation is triggered in part by post-partum environmental changes3, but the molecules orchestrating cardiomyocyte maturation remain unknown. Here we show that this transition is coordinated by maternally supplied γ-linolenic acid (GLA), an 18:3 omega-6 fatty acid enriched in the maternal milk. GLA binds and activates retinoid X receptors4 (RXRs), ligand-regulated transcription factors that are expressed in cardiomyocytes from embryonic stages. Multifaceted genome-wide analysis revealed that the lack of RXR in embryonic cardiomyocytes caused an aberrant chromatin landscape that prevented the induction of an RXR-dependent gene expression signature controlling mitochondrial fatty acid homeostasis. The ensuing defective metabolic transition featured blunted mitochondrial lipid-derived energy production and enhanced glucose consumption, leading to perinatal cardiac dysfunction and death. Finally, GLA supplementation induced RXR-dependent expression of the mitochondrial fatty acid homeostasis signature in cardiomyocytes, both in vitro and in vivo. Thus, our study identifies the GLA-RXR axis as a key transcriptional regulatory mechanism underlying the maternal control of perinatal cardiac metabolism.S

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials.

Funder: laura and john arnold foundationBACKGROUND: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ). METHODS: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. RESULTS: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. CONCLUSIONS: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

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