Diseño y simulación de una silla de ruedas autónoma que permita subir y bajar escalones a su usuario

El Consejo Nacional de Discapacidades, CONADIS, y el Instituto Nacional del Niño y la Familia, INNFA del Ecuador realizaron una investigación donde se concluyó que el 13.2% de la población ecuatoriana tiene algún tipo de discapacidad, es decir una limitación de carácter permanente para realizar una actividad como la realizan las otras personas y aproximadamente el 10.1% de personas son usuarios de sillas de ruedas o de ayudas técnicas. Por este motivo en nuestro país se han estado realizando investigaciones y desarrollando nuevos dispositivos con capacidades motoras mejoradas para poder reintegrar a las personas a su vida laboral, pero ninguna que permita a su usuario subir y bajar escaleras; esta fue la razón por la cual se decidió realizar el diseño de una silla de ruedas autónoma que permita subir y bajar escalones a su usuario. Para comenzar con el diseño se investigó sobre los diferentes tipos de sillas de ruedas que existen en el mercado y los mecanismos que estos poseen, con lo que se pudo seleccionar las mejores cualidades y atributos de cada una. Simultáneamente se investigó la norma ecuatoriana de arquitectura y la norma internacional de construcción de sillas de ruedas, para tener un panorama general sobre las dimensiones que debía tener nuestro prototipo. Con las cualidades y atributos seleccionados y las dimensiones fijadas por norma, se procedió a analizar los diferentes elementos que serían utilizados en nuestro prototipo de silla de ruedas, para su posterior diseño y cálculo. Con todos los elementos diseñados y calculados se procedió a realizar la simulación de la silla de ruedas con la que se comprobó que el mecanismo utilizado era totalmente viable. Con la información obtenida se concluyó que nuestro prototipo era estable y seguro para su usuario, además le permite tener una autonomía total al momento de la conducción

Development of a Panel of Genome-Wide Ancestry Informative Markers to Study Admixture Throughout the Americas

Most individuals throughout the Americas are admixed descendants of Native American, European, and African ancestors. Complex historical factors have resulted in varying proportions of ancestral contributions between individuals within and among ethnic groups. We developed a panel of 446 ancestry informative markers (AIMs) optimized to estimate ancestral proportions in individuals and populations throughout Latin America. We used genome-wide data from 953 individuals from diverse African, European, and Native American populations to select AIMs optimized for each of the three main continental populations that form the basis of modern Latin American populations. We selected markers on the basis of locus-specific branch length to be informative, well distributed throughout the genome, capable of being genotyped on widely available commercial platforms, and applicable throughout the Americas by minimizing within-continent heterogeneity. We then validated the panel in samples from four admixed populations by comparing ancestry estimates based on the AIMs panel to estimates based on genome-wide association study (GWAS) data. The panel provided balanced discriminatory power among the three ancestral populations and accurate estimates of individual ancestry proportions (R2>0.9 for ancestral components with significant between-subject variance). Finally, we genotyped samples from 18 populations from Latin America using the AIMs panel and estimated variability in ancestry within and between these populations. This panel and its reference genotype information will be useful resources to explore population history of admixture in Latin America and to correct for the potential effects of population stratification in admixed samples in the region

Federaciones de las Américas: descentralización, relaciones intergubernamentales y recentralización

La literatura sobre federalismo es muy amplia en términos teóricos y empíricos, no obstante, los estudios han prestado poca atención a la comparación entre las cinco federaciones americanas. Se asume, no siempre con fundamentos suficientes, que el modelo americano es el caso paradigmático de federalismo, de forma que los países latinoamericanos son considerados como desviaciones. Por lo tanto, existe una laguna que será subsanada con este estudio sobre las cinco federaciones americanas, pues a excepción de trabajos que comparan Estados Unidos con algún país latinoamericano o con Canadá, la literatura es carente de un análisis que discuta este tema en forma más amplia. Ese es el principal objetivo de esta obra: ofrecer al lector un análisis comparativo de los cinco países americanos que adoptan la forma federal de organización del Estado nacional: Argentina, Brasil, Canadá, Estados Unidos y México. La brecha existente en este campo de estudios se vuelve aún más pronunciada en vista de los cambios significativos que alteraron la organización política y administrativa de los países latinoamericanos, como la reanudación de la democracia hace tres décadas, principalmente en Argentina y Brasil, más la inclinación autoritaria y centralizadora de otros gobiernos nacionales, como es el caso de México. No menos importantes han sido los cambios en el federalismo americano, que combinan procesos de devolución con la ampliación de la actuación regulatoria. En Canadá, la evolución del modelo político de la federación generó cambios menos profundos. En cualquier caso, para el período que va desde la década de los ochenta hasta la fecha, los cambios en la estructura y funcionamiento de las cinco federaciones han motivado debates entre los estudiosos del tema. Este libro pretende presentar a los investigadores del área temática las principales tendencias en curso sobre ese debate. Las expresiones y conceptos pueden diferir en su forma, pero acaban por expresar una comprensión de los tres procesos que permiten realizar este análisis comparativo: 1) descentralización, considerada como un amplio espectro entre la no centralización hasta la concentración decisoria en la esfera nacional; 2) relaciones intergubernamentales (RIG) y sus arreglos de coordinación y cooperación entre diferentes niveles de gobierno y las políticas públicas inherentes, y 3) procesos de recentralización que, recientemente, asumen matices distintos en cada país estudiado, igualmente distribuidos en un espectro que va desde la ausencia total del modelo hasta la restitución de atribuciones previamente descentralizadas/delegadas/devueltas a los gobiernos subnacionales. En resumen, este libro se justifica por dos razones básicas: se trata del primer esfuerzo académico de comparación sistemática entre las cinco federaciones americanas y, particularmente, organiza ese debate en torno a las tres dimensiones clave sobre las que han orbitado los procesos de cambio o de refuerzo de las características basales de las federaciones americanas

Impact of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients: A nationwide study in Spain

Objective To assess the effect of the first wave of the SARS-CoV-2 pandemic on the outcome of neurosurgical patients in Spain. Settings The initial flood of COVID-19 patients overwhelmed an unprepared healthcare system. Different measures were taken to deal with this overburden. The effect of these measures on neurosurgical patients, as well as the effect of COVID-19 itself, has not been thoroughly studied. Participants This was a multicentre, nationwide, observational retrospective study of patients who underwent any neurosurgical operation from March to July 2020. Interventions An exploratory factorial analysis was performed to select the most relevant variables of the sample. Primary and secondary outcome measures Univariate and multivariate analyses were performed to identify independent predictors of mortality and postoperative SARS-CoV-2 infection. Results Sixteen hospitals registered 1677 operated patients. The overall mortality was 6.4%, and 2.9% (44 patients) suffered a perioperative SARS-CoV-2 infection. Of those infections, 24 were diagnosed postoperatively. Age (OR 1.05), perioperative SARS-CoV-2 infection (OR 4.7), community COVID-19 incidence (cases/10 5 people/week) (OR 1.006), postoperative neurological worsening (OR 5.9), postoperative need for airway support (OR 5.38), ASA grade =3 (OR 2.5) and preoperative GCS 3-8 (OR 2.82) were independently associated with mortality. For SARS-CoV-2 postoperative infection, screening swab test <72 hours preoperatively (OR 0.76), community COVID-19 incidence (cases/10 5 people/week) (OR 1.011), preoperative cognitive impairment (OR 2.784), postoperative sepsis (OR 3.807) and an absence of postoperative complications (OR 0.188) were independently associated. Conclusions Perioperative SARS-CoV-2 infection in neurosurgical patients was associated with an increase in mortality by almost fivefold. Community COVID-19 incidence (cases/10 5 people/week) was a statistically independent predictor of mortality. Trial registration number CEIM 20/217

Corrigendum to ‘a horizon scan exercise for aquatic invasive alien species in Iberian inland waters’

info:eu-repo/semantics/publishedVersio

Black list and Alert list of the Aquatic Invasive Alien Species in the Iberian Peninsula: an action of the LIFE INVASAQUA

Resumen del trabajo presentado en VI Congreso Nacional sobre Especies Exóticas Invasoras y I Congreso Ibérico sobre EEI (EEI 2022) celebrado en Navarra del 20 al 23 de abril de 2022.One of the objectives of LIFE INVASQUA project is to develop tools that will be more efficient the Early Warning and Rapid Response (EWRR) framework for Invasive Alien Species in the Iberian Peninsula. Horizon scanning for high-risk IAS is basic in implementing measures to reduce new invasions, developing Alert lists, and to focus effort in the species already established, for instance making a Black list. We developed a trans national horizon scanning exercise focused on inland waters of Spain and Portugal in order to provide a prioritized lists (Black list and Alert list) of aquatic IAS that may pose a threat to aquatic ecosystems and socio economic sectors in the future. We followed a step approach of existing information about IAS (Plants, Freshwater Invertebrates, Estuarine Invertebrates and Vertebrates; 127 established taxa in Black list; 90 non established taxa in Alert list) combining with an expert scoring of prioritized taxa. IAS established in the Iberian aquatic system consistently highlighted as the worst included vertebrates (e.g. Cyprinus carpio, Gambusia holbrooki, Silurus glanis), freshwater and estuarine invertebrates (e.g. Procambarus clarkii, Dreissena polymorpha, Pacifastacus leniusculus, Ficopomatus enigmaticus, Callinectes sapidus, Corbicula fluminea) and plants (e.g. Eichhornia crassipes, Azolla filiculoides, Ludwigia grandiflora). Amongst taxa not yet established (Alert list), expert pointed to Perna viridis, Hydroides dirampha, Dreissena bugensis, Procambarus fallax f. virginallis, Perccottus glenii with higher risk of invasion, ecological and socioeconomic impacts. Over 20.6% of the taxa in the preliminary black list received no votes (no prioritization) by experts, 17.8% in the innitial alert list. Our horizon scanning approach is inclusive of all-taxa, prioritizes both established and emerging biological threats across trans-national scales, and considers not only the ecological impact, but also potential direct economic consequences as well as the manageability of invasive species.This work received funds from the LIFE Programme (LIFE17 GIE/ES/000515)

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

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

Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector

A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results

Envejecimiento de la población

&bull;Actividades b&aacute;sicas de la vida diaria en personas mayores y factores asociados &bull;Asociaci&oacute;n entre depresi&oacute;n y posesi&oacute;n de mascotas en personas mayores &bull;Calidad de vida en adultos mayores de Santiago aplicando el instrumento WHOQOL-BREF &bull;Calidad de vida en usuarios con enfermedad de Parkinson, demencia y sus cuidadores, comuna de Vitacura &bull;Caracterizaci&oacute;n de egresos hospitalarios de adultos mayores en Puerto Natales (2007-2009) &bull;Comportamiento de las patolog&iacute;as incluidas como GES para el adulto mayor atendido en un Cesfam &bull;Contribuci&oacute;n de vitaminas y minerales a las ingestas recomendadas diarias en ancianos institucionalizados de Madrid &bull;Estado de salud oral del paciente inscrito en el Programa de Visita Domiciliaria &bull;Evaluaci&oacute;n del programa de discapacidad severa en Casablanca con la matriz de marco l&oacute;gico &bull;Factores asociados a satisfacci&oacute;n vital en una cohorte de adultos mayores de Santiago, Chile &bull;Pauta instrumental para la identificaci&oacute;n de riesgos para el adulto mayor autovalente, en su vivienda &bull;Perfil farmacol&oacute;gico del paciente geri&aacute;trico institucionalizado y posibles consecuencias en el deterioro cognitivo &bull;Programa de cuidados paliativos y alivio del dolor en Puerto Natales &bull;Rehabilitaci&oacute;n mandibular implantoprot&eacute;sica: efecto en calidad de vida relacionada con salud bucal en adultos mayores &bull;Salud bucodental en adultos mayores autovalentes de la Regi&oacute;n de Valpara&iacute;so &bull;Transici&oacute;n epidemiol&oacute;gica y el estudio de carga de enfermedad en Brasi

Randomized Controlled Trial Assessing the Impact of Tacrolimus Versus Cyclosporine on the Incidence of Posttransplant Diabetes Mellitus

Despite the high incidence of posttransplant diabetes mellitus (PTDM) among high-risk recipients, no studies have investigated its prevention by immunosuppression optimization. We conducted an open-label, multicenter, randomized trial testing whether a tacrolimus-based immunosuppression and rapid steroid withdrawal (SW) within 1 week (Tac-SW) or cyclosporine A (CsA) with steroid minimization (SM) (CsA-SM), decreased the incidence of PTDM compared with tacrolimus with SM (Tac-SM). All arms received basiliximab and mycophenolate mofetil. High risk was defined by age >60 or >45 years plus metabolic criteria based on body mass index, triglycerides, and high-density lipoprotein-cholesterol levels. The primary endpoint was the incidence of PTDM after 12 months. The study comprised 128 de novo renal transplant recipients without pretransplant diabetes (Tac-SW: 44, Tac-SM: 42, CsA-SM: 42). The 1-year incidence of PTDM in each arm was 37.8% for Tac-SW, 25.7% for Tac-SM, and 9.7% for CsA-SM (relative risk [RR] Tac-SW vs. CsA-SM 3.9 [1.2-12.4; P = 0.01]; RR Tac-SM vs. CsA-SM 2.7 [0.8-8.9; P = 0.1]). Antidiabetic therapy was required less commonly in the CsA-SM arm (P = 0.06); however, acute rejection rate was higher in CsA-SM arm (Tac-SW 11.4%, Tac-SM 4.8%, and CsA-SM 21.4% of patients; cumulative incidence P = 0.04). Graft and patient survival, and graft function were similar among arms. In high-risk patients, tacrolimus-based immunosuppression with SM provides the best balance between PTDM and acute rejection incidence