Mixed oxides of manganese and copper with different wt% of copper have been prepared and evaluated in ethanol combustion. The co-precipitation method used for the synthesis of Mn
xCu
y mixed oxides ...is adequate to obtain catalysts with excellent catalytic performance in combustion reactions. Catalysts were characterized by means of XRD, FT-IR, TPR and O
2-TPD. A small amount of copper prevents manganese oxide reaching a crystalline structure. This poor crystalline structure of manganese oxide may improve the existence of oxygen vacancies giving a best performance in ethanol combustion to CO
2. When the copper content increases, an extent of solid state reaction between Cu and Mn is favored and the partial oxidation of ethanol becomes more important. The incorporation of manganese into incomplete spinel structure diminishes CO
2 yield.
Abstract This study aimed to describe the prevalence of high‐risk human papillomavirus (HR‐HPV) types in the anal canal in a cohort of people living with HIV (PLWHIV) with a history of malignancy. ...Setting Referral tertiary care hospital for adult patients with cancer. Methods We reviewed data of patients from the AIDS Cancer Clinic on antiretroviral therapy in chronic control who were consecutively referred for high‐resolution anoscopy (HRA), where they underwent anal evaluation, collection of specimens for anal cytology and anal human papillomavirus (HPV) followed by HRA with directed biopsy if needed. Results A total of 155 patients were included; 149 (96.1%) were men, all of them men who have sex with men (MSM); the median age was 39 (IQR 32‐47) years; 105 (67.7%) with Kaposi sarcoma, 40 (25.8%) with non‐Hodgkin lymphoma and 10 (6.4%) with other neoplasms; only 7 (4.5%) had active cancer. The prevalence of HR‐HPV infection was 89% ( n =138) (95% CI 83–93) with at least one HR‐HPV infection, and 62% (96) had coinfection with at least two types; the median HR‐HPV types of coinfection were 3 (IQR 2–4). The number of patients infected with HPV 16 was 64 (41.3%, 95% CI 33.8–49.3), HPV 18 was 74 (47.7%, 95% CI 39.9–55.7) and with both 35 (22.6%). Some 59 patients (38%) had high‐grade squamous intraepithelial lesions (HSIL) and 49 (31.6%) had low‐grade squamous intraepithelial lesions (LSIL). The prevalence of HR‐HPV and HSIL among patients aged ≤35 and >35 years was the same. Conclusions In this cohort of PLWHIV with a history of malignancy we found a high prevalence of HR‐HPV 16 and 18 and anal HSIL, even in persons aged ≤35 years. These data highlight the importance of anal cancer screening in PLWHIV and history of malignancy.
Mechanochemical activation was assessed using Pd-based catalysts supported on high-energy ball milled ceria. By means of different milling conditions, improved physicochemical properties were ...achieved, including defects introduction, surface area increase and redox development that remained even after palladium impregnation and thermal steps of synthesis. Furthermore, palladium particles were effectively added to supports’ surface in small metal domains with Pd0 predominance. Strong metal-support interaction was also attained, including the formation of Pd–O–Ce solid solutions and interfacial sites. However, distinctive acid-base properties and oxygen vacancies achieved in the supports were at certain degree lost during catalysts preparation, having a main impact on catalytic activity. Glycerol selective oxidation tests showed an unexpected catalytic behavior for Ce5002 support by itself, achieved by a simple mechanochemical activation, and comparable to Pd/Ce00 catalyst. Therefore, high-energy ball milling gives new approaches of design for catalysts and robust supports that can act as catalysts by themselves.
Display omitted
•Support's contribution needs to be considered during catalyst design.•Physicochemical features can be optimized by mechanochemical treatment.•Supports might convert into catalysts by a simple mechanochemical activation.•High-energy ball milling serves as a stand-alone technique for catalysts production.
Palladium catalysts supported on defective mixes of anatase, TiO2 (II) and rutile crystalline phases, previously obtained by high-energy ball milling, were synthesized and tested for glycerol ...selective oxidation. A deep characterization of these unusual materials was carried out to elucidate catalytic and physicochemical features. Electron density transfer from support to metal or vice versa, depending on the polymorphs present, could not only alter palladium particle sizes and its surface oxidation state but also reducibility and oxygen mobility of catalysts. Furthermore, acid-base properties achieved also influenced catalytic activity under mild conditions of liquid-phase glycerol oxidation. A conversion of 94% and a selectivity to glyceric and lactic acids of 48% and 22% respectively were obtained for the Pd catalyst supported on mechanochemically activated anatase. The presence of several polymorphs in a metal oxide support could therefore benefit or handicap catalytic cycle for a particular reaction. Metal-support interactions play a key role in heterogenous catalysts and thus the rational design of supports comes on the scene.
Display omitted
•Catalysts with distinctive redox and acid-base properties were obtained.•Direction of electron transfer between metal and support is altered by TiO2 phases.•The presence of different TiO2 polymorphs has a major effect on glycerol oxidation.•Metal-support interactions could be improved through a rational design of supports.•A simple mechanochemical activation is capable of enhancing catalytic features.
To describe the development of educational materials for parents and other caregivers of children with cancer, which utilized a culturally sensitive approach to reduce acceptance barriers to ...palliative care (PC).
The Pan American Health Organization (PAHO), St. Jude Children's Research Hospital, and partners in Latin America and the Caribbean collaborated in a three-phase project, beginning with a needs assessment survey of caregivers of children with cancer in Peru. Based on this finding, an interdisciplinary team of pediatric PC experts developed educational content that was designed and validated by an international committee of PC and communication experts.
The collaboration resulted in the development of an eight-module series that introduces caregivers to key concepts of pediatric PC, including management of pain, quality of life, and end of life care. The series was designed to reduce caregiver stigma associated with PC through culturally sensitive education that addresses the low levels of health literacy among caregivers in Latin America and the Caribbean. In the 15 months since the launch, these modules have been distributed throughout Latin America and were downloaded 2 825 times.
Educational materials and anticipatory guidance of PC were considered to be a priority for parents and other caregivers of children with cancer throughout Latin America. The materials developed through this project have been widely utilized and are available through the PAHO website and the
online resource.
El 4 de diciembre de 2018 se publicó en La Gaceta de Costa Rica el Decreto Legislativo Nº 9635 titulado Fortalecimiento de las Finanzas Públicas, el cual, en su título I, realiza una reforma integral ...de la Ley Nº 6826 (Ley del Impuesto General sobre las Ventas) del 8 de noviembre de 1982. Esta ley transforma el Impuesto General sobre las Ventas (IGV) en un Impuesto al Valor Agregado (IVA), estableciéndose diferentes tasas impositivas para diferentes subgrupos de bienes y servicios. El objetivo de este documento es presentar los resultados del análisis realizado sobre el impacto de la implementación del IVA sobre los diferentes deciles de ingreso en el país (cada decil se compone de un 10% de los hogares). Se determina que si bien la mayor contribución monetaria (recaudación fiscal) estaría realizada por los hogares provenientes de los deciles más altos, son los hogares de los deciles inferiores los que serían más afectados en relación con su nivel de ingresos, ya que los primeros tres deciles -según la Encuesta Nacional de Ingresos y Gastos de 2013-, gastan más de lo que obtienen por ingresos, lo que implica que el pago de una mayor cantidad de impuestos afectará de manera importante su capacidad de consumo, por lo que se requerirá del apoyo del Estado para contrarrestar este efecto.
: Children with cancer experience significant pain and anxiety during needle-based procedures. Undertreated pain in children has long-lasting consequences and reduces the efficacy of subsequent ...analgesic efforts. A validated quality improvement (QI) intervention, known as the "Children's Comfort Promise", includes (1) topical anesthetics, (2) sucrose or breastfeeding for infants, (3) comfort positioning, and (4) distraction techniques, and has been shown to be highly effective in decreasing procedural pain and anxiety in children. However, there is limited data about the adoption, adaptation, and implementation of these interventions in low- and middle-income countries (LMICs).
: A QI pilot project utilizing the Model for Improvement of the "Global Comfort Promise" was implemented in four global pediatric cancer hospitals (Lima, Peru; Barretos, Brazil; Pietermaritzburg, South Africa; and Manila, Philippines). Between August 2021 and January 2023, the pilot sites identified a specific aim, co-designed the measurement strategy with St. Jude Children's Research Hospital, and adopted, adapted, and implemented the project at their individual sites.
: A total of 2,185 different procedures were recorded in the first year of implementation. Most patients were less than 10 years old (60.5%) and solid tumors (37.9%) were the most common diagnosis. Overall, healthcare professionals (98.3%) were satisfied with the procedures. Parents and patients reported that only 33.7% of patients experienced pain during the procedure. All (100%) parents and patients felt the healthcare teams adequately addressed their child's pain. Median self-reported adherence to ≥2 interventions was 98.0%. Challenges to the implementation of the QI initiative included lack of training, turnover of the medical staff, maintaining staff enthusiasm, and access to topical anesthetics. Each site had unique change ideas to implement the initiative.
: This multi-site, multi-country QI initiative was feasible and was successfully adopted, adapted, and implemented in the LMIC context to improve procedural pain in children (Global Comfort Promise). Additionally, this intervention resulted in high satisfaction of both healthcare professionals and patients/families. Further work is needed to overcome the challenges of topical anesthetic access and education of the workforce. Additional plans include modifying the Global Comfort Promise to include high-quality communication and expanding to additional sites with further refinement of the implementation strategy.
Fiscal rules are mechanisms designed to achieve a sustainable public debt path, trying to maintain spending growth or a fiscal result consistent with that objective. Although there were several ...attempts to apply a similar mechanism in Costa Rica, it was not until the approval of the 2018 tax reform that it was formally introduced. Designed to function under normal conditions, the Covid-19 pandemic revealed many problems in the application of the mechanism for Costa Rica, which have been exacerbated by a restrictive fiscal policy. Many problems that could generate operational difficulties in public entities would become greater as long as the fiscal rule remains unadjusted, hence the need for specific reforms to ensure reasonable application.
As regras fiscais são mecanismos criados para alcançar uma trajetória sustentável da dívida pública, buscando manter o crescimento dos gastos ou um resultado fiscal consistente com esse objetivo. Embora tenha havido várias tentativas de implementar um mecanismo semelhante na Costa Rica, ele não foi introduzido formalmente até a aprovação da reforma fiscal de 2018. Projetado para operar em condições normais, a pandemia da Covid-19 expôs muitos problemas na implementação do mecanismo na Costa Rica, que foram exacerbados pela política fiscal restritiva. Muitos problemas que poderiam gerar dificuldades operacionais em entidades públicas se tornariam maiores à medida que a regra fiscal permanecesse sem ajustes, daí a necessidade de reformas direcionadas para garantir uma implementação razoável.
Las reglas fiscales son mecanismos diseñados para alcanzar una senda sostenible de deuda pública, tratando de mantener un crecimiento del gasto o un resultado fiscal, consistente con ese objetivo. Si bien hubo varios intentos de aplicación de un mecanismo similar en Costa Rica, no fue sino hasta la aprobación de la reforma fiscal del 2018, que se introdujo formalmente. Diseñado para funcionar en condiciones normales, la pandemia del Covid-19 dejó ver muchos problemas en la aplicación del mecanismo para Costa Rica, que se han venido exacerbando con una política fiscal restrictiva. Muchos problemas que podrían generar dificultades operativas en entidades públicas se harían mayores conforme la regla fiscal se mantenga sin ajustes, de ahí la necesidad de reformas puntuales, para asegurar una aplicación razonable.
BackgroundPaediatric Early Warning Systems (PEWSs) improve identification of deterioration, however, their sustainability has not been studied. Sustainability is critical to maximise impact of ...interventions like PEWS, particularly in low-resource settings. This study establishes the reliability and validity of a Spanish-language Clinical Sustainability Assessment Tool (CSAT) to assess clinical capacity to sustain interventions in resource-limited hospitals.MethodsParticipants included PEWS implementation leadership teams of 29 paediatric cancer centres in Latin America involved in a collaborative to implement PEWS. The CSAT, a sustainability assessment tool validated in high-resource settings, was translated into Spanish and distributed to participants as an anonymous electronic survey. Psychometric, confirmatory factor analysis (CFA), and multivariate analyses were preformed to assess reliability, structure and initial validity. Focus groups were conducted after participants reviewed CSAT reports to assess their interpretation and utility.ResultsThe CSAT survey achieved an 80% response rate (n=169) with a mean score of 4.4 (of 5; 3.8–4.8 among centres). The CSAT had good reliability with an average internal consistency of 0.77 (95% CI 0.71 to 0.81); and CFAs supported the seven-domain structure. CSAT results were associated with respondents’ perceptions of the evidence for PEWS, its implementation and use in their centre, and their assessment of the hospital culture and implementation climate. The mean CSAT score was higher among respondents at centres with longer time using PEWS (p<0.001). Focus group participants noted the CSAT report helped assess their centre’s clinical capacity to sustain PEWS and provided constructive feedback for improvement.ConclusionsWe present information supporting the reliability and validity of the CSAT tool, the first Spanish-language instrument to assess clinical capacity to sustain evidence-based interventions in hospitals of variable resource levels. This assessment demonstrates a high capacity to sustain PEWS in these resource-limited centres with improvement over time from PEWS implementation.
Resumen El objetivo de la investigación es caracterizar a la población inmigrante (desde una perspectiva de género), así como su participación en el mercado laboral costarricense, de manera que los ...resultados puedan ser utilizados por otras personas investigadoras interesadas en temas migratorios, así como por autoridades de gobierno y organizaciones sociales, para la elaboración de políticas públicas en esta materia. En ese sentido, en el documento se presenta un análisis, a partir de información extraída y procesada de la base de datos de la Encuesta Continua de Empleo (ECE), que trimestralmente realiza el Instituto Nacional de Estadística y Censos de Costa Rica (INEC); particularmente de los datos para el segundo trimestre de 2018. Se presenta una caracterización de las personas inmigrantes (nacidas en otro país) en el nivel nacional, por región de planificación, por país de procedencia, por grupos de edad y por sexo. Adicionalmente, se realiza un análisis detallado de las personas ocupadas, desempleadas, y del perfil educativo de la población inmigrante en fuerza de trabajo.
PDF
