Abstract
The National Soil Strategy for Sustainable Agriculture (ENASAS) arises in response to the increasing need to organize, coordinate and strengthen the implementation of actions oriented to the ...sustainable management of Mexico's agricultural soils. The measures recommended in this paper allow the conservation and maintenance of soils' essential functions for agriculture, food security and population well‐being. The health and quality of agricultural soils are under constant pressure from several factors, mainly anthropogenic. One of ENASAS's objectives is to identify and stop the causes involved in land degradation processes using a systemic approach. From this perspective, the participation of various actors in sustainable soil management allows the integration of different systems, practices, techniques and knowledge that promotes awareness among the entire population about the importance of soil resources. On the other hand, given current limitations on the availability of information necessary to support decision‐making and evaluate the result of the actions implemented, ENASAS promotes the generation of tools that provide reliable and updated data regarding Mexico's agricultural soils. In the same sense, this strategy encourages the development of scientific and technological research and the transfer of knowledge that meets the needs of farmers, particularly those who carry out their activities on a smaller scale. This perspective describes ENASAS as a multi‐institutional initiative that will support sustainable soil management practices across the country's agricultural systems of Mexico and contribute to the adaptation and mitigation of global environmental change.
The aim of this study is to present and analyze the vaginal delivery checklist as a safe and useful learning tool for first-year residents in the gynecology and obstetrics and midwifery specialties ...at different hospitals and to analyze the items that comprise it and the progress of the residents during the first 30 normal deliveries attended in a supervised manner. We present a descriptive, observational and prospective study in which 18 participants from different hospitals in Spain completed a checklist of skills in the first 30 births attended autonomously after learning its use in a simulation workshop. We collected a total of 329 of 330 checklists completed by 11 participants. In addition, the mean responses for each item contained on the checklist and the mean global progression of the participants were subsequently analyzed, detecting statistically significant differences using Student's t-test for paired data. During the data collection period between September 2020 and August 2021, a total of 329 checklists were analyzed. The global average of positive responses for the 30 questions contained on the checklist was 25.36 out of 30 points. The fulfillment of the different items was variable, with the lowest fulfillment of 2.18 points, although 73% of the items obtained a score greater than 25. A statistically significant difference in the mean compliance of the first five childbirths compared to the last five deliveries using the proposed checklist was obtained, with
< 0.01. In conclusion, knowing the importance of using a checklist to anticipate risk situations and reduce the number of adverse perinatal outcomes, we can say that, for first-year residents in gynecology and obstetrics attending a clinical simulation workshop in eutocic vaginal delivery, it may be interesting to have a tool, such as the checklist proposed in this study, that facilitates the learning process and the suitable progress of the participants.
Constantly growing environmental concerns focused on reducing pollution, in addition to rising fuel costs in recent years, have led the maritime industry to develop and implement fuel-saving ...solutions. Among them is the optimization of marine propeller efficiency, as marine propellers are a crucial part of ship’s propulsion system. During the initial design stage, selecting the optimal propeller is considered a multi-objective optimization process. This research focused on maximizing propeller open water efficiency, while minimizing engine brake power constrained by thrust and cavitation. Optimization was applied to Wageningen B-series propellers and conducted using the Non-Dominated Sorting Genetic Algorithm II (NSGA-II). The algorithm selected optimum parameters to create the propeller model, which was then evaluated numerically through computational fluid dynamics (CFD) with a multiple reference frame (MRF) and under the SST k-ω turbulence model, to obtain the open water hydrodynamic characteristics. In addition, the cavitation effect was evaluated using the Zwart–Gerber–Belamri cavitation model. The numerical model results were validated through comparison with open water experimental data from the Netherlands Ship Model Basin for the Wageningen B-series propellers. The results showed errors of 3.29% and 2.01% in efficiency under noncavitating and cavitating conditions, respectively. Correct performance of the functions was shown, based on neural networks trained to estimate thrust and torque coefficients instead of polynomials. The proposed optimization process and numerical model are suitable for solving multi-objective optimization problems in the preliminary design of fixed-pitch marine propellers.
Cardiovascular (CV) disease is the main cause of mortality in axial spondyloarthritis (axSpA). CV risk is enhanced by dysregulation of adipokines. Low omentin levels were associated with metabolic ...dysfunction and CV disease in conditions different from axSpA. Accordingly, we evaluated the genetic and functional implication of omentin in CV risk and subclinical atherosclerosis in a cohort of 385 axSpA patients. Subclinical atherosclerosis was evaluated by carotid ultrasound. Omentin rs12409609, in linkage disequilibrium with a polymorphism associated with CV risk, was genotyped in 385 patients and 84 controls. Serum omentin levels were also determined. omentin mRNA expression was assessed in a subgroup of individuals. Serum and mRNA omentin levels were lower in axSpA compared to controls. Low serum omentin levels were related to male sex, obesity, inflammatory bowel disease (IBD) and high atherogenic index. rs12409609 minor allele was associated with low omentin mRNA expression in axSpA. No association was observed with subclinical atherosclerosis at the genetic or functional level. In conclusion, in our study low omentin serum levels were associated with CV risk factors in axSpA. Furthermore, rs12409609 minor allele may be downregulating the expression of omentin. These data support a role of omentin as a CV risk biomarker in axSpA.
To compare pelvic floor disorders between vaginal delivery (VD) and cesarean delivery (CD).
For this study, a PUBMED database search was used, utilizing a combination of relevant medical subjects' ...headings (MeSH) terms, with the following keywords: "Pelvic floor disorders" or "Pelvic floor morbidity" and "Delivery". Search limits were articles in English or Spanish, about women, published from December 2009 to December 2019. The STATA 16 package was used for meta-analysis and data heterogeneity assessment.
Thirteen studies meeting eligibility criteria were identified comprising 1,597,303 participants. Abstract: Pelvic floor morbidity prevalence was Urinary Incontinence (UI) 27.9% (5411 patients in 7 studies with reported cases), Pelvic Organ Prolapse (POP) 14.2% (6019 patients in 8 studies with reported cases), and Anal Incontinence (AI) 0.4% (1,589,740 patients in 5 studies with reported cases). Our meta-analyses revealed significantly higher rates of all three morbidities and overall morbidity in the VD versus CD group: UI OR = 2.17, 95% CI 1.64-2.87,
for heterogeneity ≤ 0.0001,
= 84%; POP OR = 3.28, 95% CI 1.91-5.63,
for heterogenicity ≤ 0.043,
= 63%; AI OR = 1.53, 95% CI 1.32-1.77;
for heterogeneity ≤ 0.291,
= 20%; and overall morbidity (OR = 2.17, 95% CI 1.64-2.87;
for heterogeneity ≤ 0.0001,
= 84%).
Vaginal delivery is directly related to the appearance of pelvic floor disorders, mainly UI, POP, and AI. The risk of POP should be taken into higher consideration after vaginal delivery and postpartum follow-up should be performed, to identify and/or treat it at the earliest stages.
The objective of this study is to develop a genetic algorithm that uses the IGP parameterization to increase the lift coefficient (CL) of three airfoils to be used on wings of unmanned aerial ...vehicles (UAVs). The geometry of three baseline airfoils was modified by developing a genetic algorithm that operates with the IGP parameterization and performs the aerodynamic analysis using XFOIL in the MATLAB environment. Subsequently, a numerical model was made for each baseline and optimized airfoil using a commercial computational fluid dynamics (CFD) code to analyze the behavior of the lift coefficient. An increase in the average CL was obtained for the Eppler 68, MH 70, and Wortmann FX 60-126 airfoils for angles of attack ranging from 0 to 10, obtaining increments of 17.243%, 14.967%, and 10.708%, respectively. Additionally, an average 5.027% uncertainty was obtained in lift coefficient calculations between XFOIL and CFD. The utility of the IGP method and genetic algorithms for parameterizing and optimizing airfoils was demonstrated. In addition, airfoils could be tailored for a specific UAV depending on the mission profile. Volume 2 of this study will include experimental data from wind tunnel.
SARS-CoV-2 is the novel member of coronavirus responsible for the worldwide pandemic COVID-19, affecting all types of people. In this context, established research identified pregnant women as a ...susceptible group of SARS-CoV-2 infection, although there is still limited data regarding the real impact of COVID-19 in this group. With that purpose, we conducted a systematic review describing the maternal-fetal results of pregnant women infected by SARS-CoV-2, in aim to analyze the profile of the obstetric patients according to the country of origin of the publication. A total of 38 articles were included in this systematic review with 2670 patients from 7 countries, with 20 works published from China (52.6%). We reported significative differences according to the median maternal age, with Spain as the country with the highest age (34.6 years); The percentage of tabaquism; proportion of symptomatic patients in the triage; type of radiological exam (China and France conduct CT scans on all their patients in comparison to the use of chest X-Ray in the rest of the countries studied); percentages of C-sections (83.9% in China; 35.9% Spain,
< 0.001); maternal mortality rate, proportion of patients who need treatments, the use of antivirals, antibiotics, and anticoagulants as well as measurements of the newborns. Perinatal results are favorable in the majority of countries, with very low rates of vertical transmission in the majority of works. The studies collected in this review showed moderate to high index of quality. The different works describe the affectation during the first wave of the pandemic, where the pregnant woman with SARS-CoV-2 infection is generally symptomatic during the third trimester of gestation along with other factors associated with worse prognosis of the disease, such as higher age, body mass index, and further comorbidities developed during pregnancy. In the obstetric patient, proportion of C-sections are elevated together with prematurity, increasing maternal perinatal morbimortality. Differences found between countries could be based on the proper profile of the patient in each region, the period of the pandemic directly affecting how it was managed, and the variations regarding in situ medical attention.
With the arrival of chikungunya (CHIKV) and zika (ZIKV) viruses in Mexico, there was a decrease in diagnosed dengue virus (DENV) cases. During the first years of cocirculation (2015-2017), the ...algorithms established by epidemiological surveillance systems and the installed capacity limited us to one diagnostic test per sample, so there was an underestimation of cases until September 2017, when a multiplex algorithm was implemented. Therefore, the objective of this study was determine the impact of the introduction of CHIKV and ZIKV on the incidence of diagnosed DENV in endemic areas of Mexico, when performing the rediagnosis, using the multiplex algorithm, in samples from the first three years of co-circulation of these arboviruses.
For this, 1038 samples received by the Central Laboratory of Epidemiology between 2015 and 2017 were selected for this work. Viruses were identified by multiplex RT-qPCR, and the χ2 test was used to compare categorical variables. With the new multiplex algorithm, we identified 2.4 times the rate of arbovirosis as originally reported, evidencing an underestimation of the incidence of the three viruses. Even so, significantly less dengue was observed than in previous years. The high incidence rates of chikungunya and Zika coincided with periods of dengue decline. The endemic channel showed that the cases caused by DENV rose again after the circulation of CHIKV and ZIKV decreased. In addition, 23 cases of coinfection were identified, with combinations between all viruses.
The results obtained in this study show for the first time the real impact on the detected incidence of dengue after the introduction of CHIKV and ZIKV in Mexico, the degree of underestimation of these arboviruses in the country, as well as the co-infections between these viruses, whose importance clinical and epidemiological are still unknown.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
This review focuses on Pulmonary Alveolar Microlithiasis (PAM), an autosomal recessive genetic disorder characterized by calcium crystal deposits (microliths) resulting from loss of function of the ...SLC34A2 gene. PAM is a rare disease with approximately 1100 reported cases globally. The historical context of its discovery and the genetic, epidemiological, and pathophysiological aspects are discussed. PAM falls under interstitial lung diseases and is associated with pulmonary hypertension (PH), primarily categorized as Group 3 PH. The clinical manifestations, diagnostic approaches, and challenging aspects of treatment are explored. A clinical case of PAM with severe pulmonary hypertension is presented, emphasizing the importance of comprehensive evaluation and the potential benefits of phosphodiesterase-5 inhibitors (PDE5i) therapy. Despite limited therapeutic options and challenging diagnosis, this review sheds light on recent developments and emerging treatments for PAM and associated pulmonary hypertension.
We determined if a third of the dose of intravesical bacillus Calmette-Guerin (BCG) has the same efficacy than a standard dose for decreasing the risk of recurrence and progression after ...transurethral resection in patients with superficial high risk (stages T1G3 and carcinoma in situ) bladder cancer. Also, we evaluated toxic side effects.
A total of 155 patients with a mean age ± SD of 67 ± 10.1 years with superficial bladder cancer, including stages T1G3 in 90, a Tis primary tumor in 23 and associated Tis disease in 42, were enrolled and randomly assigned to be treated after transurethral resection of all visible lesions with intravesical BCG, Connaught strain (weekly × 6 and fortnightly × 6 thereafter) with the standard dose of 81 mg or with the decreased dose of 27 mg.
Median followup was 61 months (range 3 to 102). Disease recurred in 32 patients (39%) treated with the standard dose and in 33 (45%) treated with the decreased dose. Median time to recurrence was not attained in the standard dose arm and it was 63 months in the decreased dose arm. Kaplan-Meier estimates for time to recurrence did not reveal differences between the 2 doses (p = 0.405). Tumor progressed in 20 patients (24.7%) with the standard dose and in 19 (26%) with the decreased dose. Four patients (6.1%) with Tis had local extension into the prostatic urethra and ducts, including 3 (8.3%) treated with the standard dose and 1 (3.4%) treated with the decreased dose. Median time to progression was not attained in either arm. Kaplan-Meier estimates for time to progression did not differ significantly (p = 0.7997). Deferred cystectomy for progression was performed in 7 patients (8.4%) treated with the standard dose and in 7 (9.5%) of those treated with the decreased dose. Subgroup analysis by patient age, tumor status, number, size and T stage (T1G3 vs Tis) did not differ significantly. The groups did not differ in disease specific mortality, which was 12.2% in the standard dose arm and 16.4% in the decreased dose arm. Mean disease specific survival ± SE was 86.96 ± 4.14 and 83.73 ± 4.73 months, respectively.
Our results suggest that a 3-fold decreased dose of intravesical BCG is as effective as the standard dose against progression in patients with high risk stages T1G3 and Tis superficial bladder carcinoma but with significantly less toxicity.
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