16 research outputs found

    Control del mantenimiento de la vegetación en el sistema de distribución eléctrico

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    Con el paso de las generaciones, el desarrollo de las sociedades conformadas por el hombre, trae consigo un conjunto de bienes y servicios que influyen en la calidad de vida de las personas. El acceso a servicios domiciliarios de energía, agua, alcantarillado, telefonía, gas natural entre otros, lleva como consecuencia una compleja red subterránea y aérea, para su mantenimiento y distribución que debe adaptarse en buena forma a las zonas urbanas. Existen factores externos que contribuyen a un estilo de vida confortable y a su vez ayudan al desarrollo permanente de la sociedad, como contar con un buen servicio de iluminación pública y zonas verdes dentro de la ciudad que ayudan a armonizar el paisaje urbano. La presencia de espacios verdes, es importante por el impacto ecológico, porque brinda beneficios tales como mitigación del ruido, la reducción de la contaminación en el medio ambiente, regulación de la temperatura, disminución de la velocidad del viento, evita la seca de los ríos, brinda sombra creando un espacio agradable, otorga vivienda y alimento a la avifauna urbana, entre otras [21]. Las zonas verdes son parte vital e importante en espacios públicos para generar un ambiente cálido y ameno, aliviando la congestión que se vive diariamente. Por este motivo la Organización Mundial para la Salud aconseja un mínimo de 12 metros cuadrados de zona verde por habitante

    Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

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    BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

    Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

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    Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

    Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

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    Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

    Recuperación de energía en el sistema de distribución eléctrico de Medellín, sector los floricultores

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    En la ciudad de Medellín, un sector declarado como sector subnormal llamado barrio los floricultores, cuenta 300 habitantes con acceso a energía eléctrica a través de instalaciones improvisadas que no registran una medida o lectura de consumo de energía para la facturación del servicio, representando una pérdida para el operador de red EPM. El objetivo principal es la normalización de las instalaciones eléctricas que deberán cumplir con la cobertura total de los futuros usuarios del sector. El proyecto se desarrollará por medio de la contratación de personal experto, establecimiento de un almacén de materiales, ejecución de actividades, entrega de obra y documentos finales. Actualmente el proyecto se encuentra en contratación y dotación de material, herramienta y equiposThere is a certain sector in Medellin city which has been declared as a subnormal one, it is called: "Los floricultores" neighbourhood. It has around three hundred inhabitants who have access to electrical energy through an unplanned electrical system. Such an improvised system does not allow the registration of the electrical consumption that users have per month, which represents some inevitable losses for Empresas Públicas de Medellín or EPM, the company providing the service. The main objective of this study is to achieve the normalization of the electrical system that should cover the future users and customers within the context that has been described above. The project will be developped, taking the following elements and actions into account: Hiring experts, opening and settling a warehouse in order to store the necessary materials, the execution of the activities according to a schedule, the legalization of papers and the delivery of the projects. Nowadays, our study is in the stage of hiring the necessary experts, the purchase as well as the storage of supplies, tools and equipment

    Research, Innovation and Extension to the service to society, in the framework of the Sixth Conference on Social Appropriation of Knowledge (SAK)

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    Annually, the Technological University of Pereira has been carrying out some events in the line of Social Appropriation of Knowledge. This has been done through the research, innovation, and extension Vice Rectory, moreover, these sessions are framed within the institutional objective: “Define and direct the guidelines for the institutional research that strengthen the research groups and the Seedbeds, through the formation of researchers, the development of science, technology, and innovation projects or programs, as well as the generation of networks and strategic partnerships that contribute to the creation and appropriation of knowledge for the society”. Therefore, the 6th Social Appropriation of Knowledge event took place under the title of “The research, Innovation, and Extension at the service of society” which was constituted as an academic and institutional opportunity where the results of the research projects from the last 5 years were published. The results of this event revealed, once again, the high academic level in investigation development at the university. There were 11 articles divided into 6 fields: Health, Engineering, Technology, Education, Industrial Technology, and Art, in which the results obtained by the research projects from the investigation groups were shown, promoting a knowledge exchange from their authors whose intellectual formation is diverse. With this publication, as part of a permanent effort to socialize the knowledge, the university promotes the circulation of its professors, students, and general community voices, having in mind that knowledge must be transferred through different channels, strengthening the academy and society in general, according to the institutional mission that invites us to incentivize a research culture in the university community.Presentation........................................................................................................... 5 Chapter 1. Health Teaching during the pandemic: what changes did professors implement? Results of a survey in a Colombian medical program. ........................................... 9 Germán Alberto Moreno Gómez ,Rodolfo Adrián Cabrales Vega, Jairo Franco Londoño, Samuel Eduardo Trujillo Henao, Víctor Manuel Patiño Suárez Evaluation of the effectiveness of a rat, rabbit and human intestine decellularization protocol...................................................................................... 19 Julio César Sánchez Naranjo, Laura Victoria Muñoz Rincón, Andrés Felipe Quiroz Ma zuera, Andrés Mauricio García Cuevas, Cristhian David Arroyave Durán, Fabián David Giraldo Castaño, Álvaro Guerra Solarte, Juliana Buitrago Jaramillo Exploration of the filtering functions of the intestine through a filtering loop model: an experimental approach towards a feasible renal replacement.............. 31 Julio César Sánchez Naranjo, Laura Victoria Muñoz Rincón, Andrés Mauricio García Cuevas, Álvaro Guerra Solarte y Juliana Buitrago Jaramillo Chapter 2. Engineering Identification of sociodemographic factors using multivariate analysis related to the dropout of Universidad Tecnológica de Pereira undergraduate students.... 47 Nelcy N Atehortua-Sanchez, Paula Marcela Herrera, Julian D Echeverry Correa Design and Construction of an HVDC-MMC Terminal on a Low Scale to Interconnection of Windfarms to the Electrical Grid........................................ 61 Diego Alberto Montoya Acevedo, Andrés Escobar Mejía Chapter 3. Technologies Preliminary study of cytototoxic and bactericidal activities of nonpolar extracts from seeds and peel of Persea americana cv Lorena ............................................ 85 Gloria Edith Guerrero Alvarez, Daniel Steven Fernández, Daniela Londoño Ramirez Cytototoxic and bactericidal activities of nonpolar extracts from seeds and peel of Persea americana cv Hass..................................................................................... 95 Gloria Edith Guerrero Alvarez, Gustavo Alfonso Cifuentes Colorado, Paula Daniela Sandoval Mossos Chapter 4. Education Pedro Henríquez Ureña traveler and Cosmopolitan ........................................... 107 William Marín Osorio Reading and writing in the training of our teachers: a commitment of all ......... 133 María Gladis Agudelo Gil, Gloria Inés Correa Aristizábal Chapter 5. Industrial engineering Tasks design to promote metacognitive regulation in discrete event simulation ......................................................................................................... 151 María Elena Bernal Loaiza, Manuela Gómez Suta, Rosario Iodice CONTENIDO Chapter 6. Arts The media feuilleton, between fiction and reality............................................... 169 Teresita Vásquez Ramíre

    Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

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    Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

    XV International Congress of Control Electronics and Telecommunications: "The role of technology in times of pandemic and post-pandemic: innovation and development for strategic social and productive sectors"

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    La anterior selección, motivados por la aseveración de Manuel Castells -hace casi 20 años ya- que la innovación y la difusión de la tecnología parecía ser la herramienta apropiada para el desarrollo en la era de la información. Este 2020, sin embargo, ante la situación disruptiva que aquejó y aqueja a la sociedad red como una estructura social emergente de la Era de la Información basada en redes de producción, energizadas por el poder y la experiencia; falló y debe reencontrar su rumbo. Es así que los problemas acuciantes, ahora, fueron: la atención sanitaria y la superación de la epidemia de Sars Cov 2; tomó forma la, hasta entonces, visión irrealista de Castells que … no podemos avanzar con nuestros modelos de desarrollo actual, destruyendo nuestro entorno y excluyendo a la mayor parte de la humanidad de los beneficios de la revolución tecnológica más extraordinaria de la historia, sin sufrir una devastadora reacción por parte de la sociedad y la naturaleza. Fue así que el Cuarto Mundo, específicamente, donde la suficiencia de recurso humano, de capital, trabajo, información y mercado -vinculados todos a través de la tecnología- supuso que atendería eficazmente a través de la población que podía por su capacidad hacer uso racional y profesional del conocimiento, las necesidades de la mayoritaria población vulnerable y vulnerada. Por lo anterior, poner en el centro a las personas, en entornos de tarea y trabajo globales hiperconectados combinando espacios físicos, corrientes de información con canales de conexión expeditos, y formando profesionales del conocimiento que asuman y afronten los retos derivados de la transformación digital de empresas, universidades, y organizaciones, pero en condiciones de equidad y sujetos de prosperidad, será el desafío en los escenarios presentes y futuros inmediatos.The previous selection, motivated by the assertion of Manuel Castells -almost 20 years ago- that innovation and diffusion of technology seemed to be the appropriate tool for development in the information age. This 2020, however, in the face of the disruptive situation that afflicted and continues to afflict the network society as an emerging social structure of the Information Age based on production networks, energized by power and experience; He failed and must find his way again. Thus, the pressing problems now were: health care and overcoming the Sars Cov 2 epidemic; Castells' until then unrealistic vision took shape that... we cannot advance with our current development models, destroying our environment and excluding the majority of humanity from the benefits of the most extraordinary technological revolution in history, without suffering a devastating reaction from society and nature. It was thus that the Fourth World, specifically, where the sufficiency of human resources, capital, work, information and market - all linked through technology - meant that it would serve effectively through the population that could, due to its capacity, make rational use. and knowledge professional, the needs of the majority vulnerable and vulnerable population. Therefore, putting people at the center, in hyperconnected global task and work environments, combining physical spaces, information flows with expedited connection channels, and training knowledge professionals who assume and face the challenges derived from the digital transformation of companies, universities, and organizations, but in conditions of equality and subject to prosperity, will be the challenge in the present and immediate future scenarios.Bogot

    Global Survey of Outcomes of Neurocritical Care Patients: Analysis of the PRINCE Study Part 2

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    BACKGROUND: Neurocritical care is devoted to the care of critically ill patients with acute neurological or neurosurgical emergencies. There is limited information regarding epidemiological data, disease characteristics, variability of clinical care, and in-hospital mortality of neurocritically ill patients worldwide. We addressed these issues in the Point PRevalence In Neurocritical CarE (PRINCE) study, a prospective, cross-sectional, observational study. METHODS: We recruited patients from various intensive care units (ICUs) admitted on a pre-specified date, and the investigators recorded specific clinical care activities they performed on the subjects during their first 7 days of admission or discharge (whichever came first) from their ICUs and at hospital discharge. In this manuscript, we analyzed the final data set of the study that included patient admission characteristics, disease type and severity, ICU resources, ICU and hospital length of stay, and in-hospital mortality. We present descriptive statistics to summarize data from the case report form. We tested differences between geographically grouped data using parametric and nonparametric testing as appropriate. We used a multivariable logistic regression model to evaluate factors associated with in-hospital mortality. RESULTS: We analyzed data from 1545 patients admitted to 147 participating sites from 31 countries of which most were from North America (69%, N = 1063). Globally, there was variability in patient characteristics, admission diagnosis, ICU treatment team and resource allocation, and in-hospital mortality. Seventy-three percent of the participating centers were academic, and the most common admitting diagnosis was subarachnoid hemorrhage (13%). The majority of patients were male (59%), a half of whom had at least two comorbidities, and median Glasgow Coma Scale (GCS) of 13. Factors associated with in-hospital mortality included age (OR 1.03; 95% CI, 1.02 to 1.04); lower GCS (OR 1.20; 95% CI, 1.14 to 1.16 for every point reduction in GCS); pupillary reactivity (OR 1.8; 95% CI, 1.09 to 3.23 for bilateral unreactive pupils); admission source (emergency room versus direct admission [OR 2.2; 95% CI, 1.3 to 3.75]; admission from a general ward versus direct admission [OR 5.85; 95% CI, 2.75 to 12.45; and admission from another ICU versus direct admission [OR 3.34; 95% CI, 1.27 to 8.8]); and the absence of a dedicated neurocritical care unit (NCCU) (OR 1.7; 95% CI, 1.04 to 2.47). CONCLUSION: PRINCE is the first study to evaluate care patterns of neurocritical patients worldwide. The data suggest that there is a wide variability in clinical care resources and patient characteristics. Neurological severity of illness and the absence of a dedicated NCCU are independent predictors of in-patient mortality.status: publishe

    Worldwide Organization of Neurocritical Care: Results from the PRINCE Study Part 1

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