Análisis comparativo del diseño estructural aplicando la norma sismoresistente vigente y el proyecto de norma, para el proyecto Hospital UPAO en la ciudad de Trujillo

La presente tesis tiene como objetivo realizar un análisis comparativo del diseño estructural aplicando la Norma de diseño sismorresistente y el Proyecto de Norma propuesto a inicios del año 2014. Para tal análisis, aplicaremos los algoritmos propuestos por cada una de las Normativas al diseño del Hospital UPAO (de alta complejidad comprendido en la categoría III-E según La Norma Técnica de Salud). De acuerdo a los resultados estructurales obtenidos, realizaremos los metrados y presupuestos correspondientes a los elementos estructurales que conformen las estructuras, tanto en la sub-estructura, como a la súperestructura, para analizarlos de manera cuantitativa. El diseño de las estructuras se realizó de acuerdo al Reglamento Nacional de Edificaciones (RNE). En el capítulo 1, trataremos sobre los aspectos generales de la tesis, detallando los objetivos generales y específicos que nos planteamos. En el capítulo 2, ahondaremos en el marco teórico de nuestro estudio, en el cual describimos la Normatividad a aplicarse, así como una breve teoría sobre aisladores sísmicos, del software a aplicarse y de la categorización de establecimientos del sector salud. En el capítulo 3, se realiza de manera detallada el análisis comparativo del diseño estructural del Hospital UPAO mediante los softwares ETABS y SAFE, diferenciada según los algoritmos de la Norma vigente y del Proyecto de Norma.This thesis aims to conduct a comparative analysis of structural design using standard seismic design standard and the draft proposal in early 2014. For this analysis, we apply algorithms proposed by each of the regulations the design of UPAO Hospital (high complexity within the category III-E according to the technical standard of Health). According to the structural results that we obtained, we will make the quantity estimate and corresponding budget to the structural elements that constitute the structures in both sub-structures, such as the super-structure to analyze in a quantitative way. The design of the structures was performed according to the National Building Regulations (""RNE""). In Chapter 1, we will discuss about the general aspects of the thesis, explaining the aims and objectives that we set. In Chapter 2, we go into details about the theoretical framework of our study, in which we describe the regulations to be applied, and a brief theory of seismic isolators, applied software and categorizing the health sector establishments. In Chapter 3, it is made in detail the comparative analysis of the structural design of UPAO Hospital by the ETABS and SAFE software, differentiated according to the existing standard algorithms and draft.Tesi

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Where Brain, Body and World Collide

The production cross section of electrons from semileptonic decays of beauty hadrons was measured at mid-rapidity (|y| &lt; 0.8) in the transverse momentum range 1 &lt; pt &lt; 8 Gev/c with the ALICE experiment at the CERN LHC in pp collisions at a center of mass energy sqrt{s} = 7 TeV using an integrated luminosity of 2.2 nb^{-1}. Electrons from beauty hadron decays were selected based on the displacement of the decay vertex from the collision vertex. A perturbative QCD calculation agrees with the measurement within uncertainties. The data were extrapolated to the full phase space to determine the total cross section for the production of beauty quark-antiquark pairs

Centrality dependence of the charged-particle multiplicity density at mid-rapidity in Pb-Pb collisions at sNN\sqrt{s_{NN}} = 2.76 TeV

The centrality dependence of the charged-particle multiplicity density at mid-rapidity in Pb-Pb collisions at $\sqrt{s_{NN}}$ = 2.76 TeV is presented. The charged-particle density normalized per participating nucleon pair increases by about a factor 2 from peripheral (70-80%) to central (0-5%) collisions. The centrality dependence is found to be similar to that observed at lower collision energies. The data are compared with models based on different mechanisms for particle production in nuclear collisions.The centrality dependence of the charged-particle multiplicity density at mid-rapidity in Pb-Pb collisions at $\sqrt{s_{\rm NN}}$ = 2.76 TeV is presented. The charged-particle density normalized per participating nucleon pair increases by about a factor 2 from peripheral (70-80%) to central (0-5%) collisions. The centrality dependence is found to be similar to that observed at lower collision energies. The data are compared with models based on different mechanisms for particle production in nuclear collisions

Exploring the strong interaction of three-body systems at the LHC

International audienceDeuterons are atomic nuclei composed of a neutron and a proton held together by the strong interaction. Unbound ensembles composed of a deuteron and a third nucleon have been investigated in the past using scattering experiments and they constitute a fundamental reference in nuclear physics to constrain nuclear interactions and the properties of nuclei. In this work K$^{+}-$d and p$-$d femtoscopic correlations measured by the ALICE Collaboration in proton$-$proton (pp) collisions at $\sqrt{s}=13$ TeV at the Large Hadron Collider (LHC) are presented. It is demonstrated that correlations in momentum space between deuterons and kaons or protons allow us to study three-hadron systems at distances comparable with the proton radius. The analysis of the K$^{+}-$d correlation shows that the relative distances at which deuterons and proton/kaons are produced are around 2 fm. The analysis of the p$-$d correlation shows that only a full three-body calculation that accounts for the internal structure of the deuteron can explain the data. In particular, the sensitivity of the observable to the short-range part of the interaction is demonstrated. These results indicate that correlations involving light nuclei in pp collisions at the LHC will also provide access to any three-body systems in the strange and charm sectors

Exploring the strong interaction of three-body systems at the LHC

International audienceDeuterons are atomic nuclei composed of a neutron and a proton held together by the strong interaction. Unbound ensembles composed of a deuteron and a third nucleon have been investigated in the past using scattering experiments and they constitute a fundamental reference in nuclear physics to constrain nuclear interactions and the properties of nuclei. In this work K$^{+}-$d and p$-$d femtoscopic correlations measured by the ALICE Collaboration in proton$-$proton (pp) collisions at $\sqrt{s}=13$ TeV at the Large Hadron Collider (LHC) are presented. It is demonstrated that correlations in momentum space between deuterons and kaons or protons allow us to study three-hadron systems at distances comparable with the proton radius. The analysis of the K$^{+}-$d correlation shows that the relative distances at which deuterons and proton/kaons are produced are around 2 fm. The analysis of the p$-$d correlation shows that only a full three-body calculation that accounts for the internal structure of the deuteron can explain the data. In particular, the sensitivity of the observable to the short-range part of the interaction is demonstrated. These results indicate that correlations involving light nuclei in pp collisions at the LHC will also provide access to any three-body systems in the strange and charm sectors