16 research outputs found
Automatización de un deshidratador de granos de cacao
El presente trabajo surge por la necesidad de analizar y proporcionar ideas que ayuden a solucionar los diferentes métodos de secado. De acuerdo con los avances tecnológicos que se vienen dando en Colombia, y la automatización de los procesos industriales; se planteó este proyecto con el fin de ayudar a los pequeños cacaoteros del municipio de Tumaco. Donde se realizó el proceso de instrumentación y diseño de un prototipo de sistema de control, donde se controlara temperatura y humedad para que la calidad del grano sea la mejor posible, y de esta manera ayudar a los pequeños productores de la zona. Esta idea surge de la necesidad de obtener un grano de cacao de calidad por medio de un sistema de control prototipo, de bajo costo y confiable, para asegurar que el cacao, en el momento en que se está secando de manera solar, se pueda monitorear, retirándolo en el momento exacto en el cual su contenido de humedad es el ideal, para su almacenamiento y posterior venta
Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study
Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life
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
Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception
Gestión integrada de la cuenca alta del río Magdalena: instrumentos para su evaluación y planificación
Watersheds are fundamental units of analysis for the development of planning and management processes. Understanding their dynamics, structure, and functioning is the basis for territory planning and decision-making. However, their functionality and sustainable use depend on the information and knowledge of these ecosystems, as well as their regimes and responsiveness against anthropogenic interventions, variability, and climate change.
This book provides tools and methodologies for the planning and evaluation of water resources, as well as for the formulation and implementation of mechanisms for adaptation to climate change and integrated watershed management. The publication “Integral management of the upper basin of the Magdalena River: tools for its evaluation and planning” is the result of research carried out by students, professors, and graduates from the School of Agricultural, Livestock and Environmental Sciences (ECAPMA, for its Spanish acronym) of UNAD (Spanish acronym for Universidad Nacional Abierta y a Distancia), and the research group Inyumacizo, classified in an A Category group according to the Colombian Ministry of Sciences—MinCiencias.Las cuencas hidrográficas se constituyen en unidades fundamentales de análisis para el desarrollo de procesos de planificación y gestión. La comprensión de su dinámica, estructura y funcionamiento constituyen el soporte para la planificación del territorio y la toma de decisiones. Sin embargo, la funcionalidad y aprovechamiento sostenible son dependientes de la información y el conocimiento de estos ecosistemas, así como de sus regímenes y capacidades de respuesta frente a las intervenciones antrópicas, variabilidad y cambio climático.
Este libro brinda instrumentos y metodologías para la planificación y evaluación del recurso hídrico, así como en la formulación e implementación de mecanismos de adaptación al cambio climático y la gestión integrada de cuencas hidrográficas. La publicación denominada: “Gestión integrada de la cuenca alta del río Magdalena: instrumentos para su evaluación y planificación” es producto de investigaciones realizadas por estudiantes, docentes y egresados de la Escuela de Ciencias Agrícolas, Pecuarias y del Medio Ambiente (ECAPMA) de la UNAD y el grupo de investigación Inyumacizo, categorizado en A por MinCiencias.As bacias hidrográficas são unidades fundamentais de análise para o desenvolvimento de processos de planejamento e gestão. A compreensão de sua dinâmica, estrutura e funcionamento é a base para o planejamento territorial e a tomada de decisões. Entretanto, a funcionalidade e o uso sustentável dependem da informação e do conhecimento desses ecossistemas, bem como de seus regimes e capacidades para responder a intervenções antrópicas, variabilidade e mudanças climáticas.
Este livro fornece instrumentos e metodologias para o planejamento e avaliação do recurso hídrico, bem como na formulação e implementação de mecanismos de adaptação à mudança climática e gestão integrada de bacias hidrográficas. A publicação intitulada: “Gestão integrada da bacia alta do rio Magdalena: instrumentos de avaliação e planejamento” é o produto de pesquisas realizadas por estudantes, professores e graduados da Escola de Ciências Agrárias, Pecuárias e Ambientais (ECAPMA) da UNAD e do grupo de pesquisa Inyumacizo, categorizado em A pela Min-Ciencias
International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module
Modalidad auxiliar de investigación
Trabajo de grado realizado en modalidad auxiliar de investigación, para optar por el título Doctorado en Cirugía Dental, en el año 2021. Se realizó en el marco del proyecto del Centro de Investigaciones de la Facultad de Odontología Universidad de El Salvador: "Vigilancia epidemiológica de enfermedades bucales en la población atendida en UCSF y atención brindada por odontólogos en servicio social durante la pandemia de covid-19 en el año 2021
Effect of accompanying antiretroviral drugs on virological response to pegylated interferon and ribavirin in patients co-infected with HIV and hepatitis C virus
The effects of antiretroviral drugs on the response to pegylated interferon plus ribavirin remain uncertain. We evaluated whether antiretroviral drugs affected the response to pegylated interferon plus ribavirin in patients co-infected with HIV and hepatitis C virus (HCV). We conducted a retrospective analysis of two cohorts of HIV/HCV-co-infected patients treated with pegylated interferon plus ribavirin between 2001 and 2007 in Spain. The outcome measure was sustained virological response (SVR). Logistic regression models were used to test possible associations between non-response and pre-treatment characteristics, including accompanying antiretroviral drugs. The study sample comprised 1701 patients: 63% were infected with HCV genotype (G) 1 or 4 and 88% were taking highly active antiretroviral therapy (HAART). Factors independently associated with increased odds of SVR were G2 or 3, HVC RNA <500,000 IU/mL and CDC clinical category A or B. When we adjusted for these prognostic factors and dose of ribavirin/kg, the adjusted odds ratio (AOR) of SVR for patients without HAART was 1.31 [95% confidence interval (CI) 0.91-1.88; P = 0.144]. Taking the backbone of tenofovir and lamivudine/emtricitabine as a reference, we found that, with the exception of regimens including zidovudine, the effect of other nucleoside reverse transcriptase inhibitor backbones had little effect on SVR. The AOR of SVR for zidovudine and lamivudine was 0.65 (95% CI 0.46-0.93, P = 0.017). We carried out several sensitivity analyses, the results of which were consistent with the findings of the primary analysis. In conclusion, our results suggest that, with the exception of regimens including zidovudine, accompanying antiretroviral drugs have little effect on the virological response to pegylated interferon plus ribavirin in HIV/HCV-co-infected patients.5.068 JCR (2011) Q1, 7/70 Infectious diseases, 18/114 Microbiology, 20/261 Pharmacology & pharmac