Desenlaces maternos y fetales en el manejo expectante de la preeclampsia lejos del término

Introducción La preeclampsia hace parte del espectro de los trastornos hipertensivos asociados al embarazo y es causa de alta morbimortalidad materna. La edad gestacional ha sido relacionada con la presentación más severa de esta cuando ocurren lejanas al término. Hoy en día existe la posibilidad de proporcionar manejo expectante en estos casos en unidades de cuidado obstétrico especializadas, con el fin de disminuir el riesgo de morbimortalidad asociada a la prematurez extrema. Metodología Se realizó un estudio de corte transversal que incluyó pacientes con preeclampsia lejos del término entre las 24 y 34 semanas que recibieron manejo expectante entre 2009 y 2012 en la Unidad de Cuidado Intensivo Obstétrico de la Clínica Colsubsidio Orquídeas. Resultados Se incluyeron 121 pacientes con preeclampsia lejos del término, quienes recibieron manejo expectante. La edad promedio fue 29.8, el promedio de días de manejo expectante fue 4 días, con una mediana de tres días. La edad gestacional de ingreso fue 30 1/7 semanas y la edad promedio de terminación 30 5/7 semanas. El 88.4% recibieron esquema de maduración completo. El 81.6% presentaron preeclampsia severa. El desenlace materno más frecuente fue Síndrome Hellp (37%) y el desenlace fetal fue restricción de crecimiento intrauterino (29%). Discusión Se debe considerar el manejo expectante en toda paciente con preeclampsia previa a la semana 34 para manejo antenatal con corticoesteroides, el cual demostró ser un factor protector para muerte perinatal temprana. No se encontraron diferencias significativas entre la aparición de complicaciones y la cantidad de días de manejo expectante.

La gestión de relaciones con clientes (CRM): sector de seguridad privada

Esta tesis pretende describir la situación actual del sector de seguridad privada, al implementar y adoptar estrategias de CRM. Con una revisión confiable y el estudio de casos relacionados con el tema, lo cual permitirá constatar la realidad en cuanto la aplicación del modelo, en el sector de seguridad privada, según lo planteado por diversos autores. Los resultados obtenidos permitirán, de este modo, al sector y a sus gerentes, desarrollar estrategias que ayuden a la satisfacción de sus clientes y a la prestación de un mejor servicio. En el campo académico, este estudio servirá como guía teórico-práctica para estudiantes y profesores, de modo que permitirá afianzar conocimientos en cuanto al CRM, al marketing relacional y su uso en el sector de seguridad privada. Según este modelo la información acerca de los clientes, es una información estratégica vital para las organizaciones que ayuda a la toma de decisiones, pronosticar cambios en cuanto a demanda, además de establecer control sobre procesos en los que se involucre el cliente; de modo que la adopción e implementación de CRM, ayude a la empresa, en este caso a las del sector de seguridad privada, a estar atentos a la manera como se interactúa con el cliente y por ende mejorar el servicio, lo que tendrá repercusión en la percepción que tenga de la organización el cliente. De este modo, se ve como en la actualidad las estrategias de CRM definen el rumbo de una empresa, ayudando atraer nuevos clientes y además de esto, ayuda de igual modo a mantener felices a los clientes actuales; lo cual repercute en la demanda o el requerimiento del servicio, y así en una mejor rentabilidad para las empresas del sector. Razones por las que el sector de vigilancia se verá beneficiado por medio de las estrategias del CRM, lo que lo llevara a ofrecer mejores servicios a sus clientes.

Estilos de liderazgo y su relación con los niveles de optimismo de los colaboradores, en entornos culturales de países suramericanos

Los estudios del liderazgo dentro de un contexto empresarial se han desarrollado para alcanzar la perdurabilidad empresarial, generar bienestar, lograr el éxito esperado, valorar el capital humano, los talentos y los recursos existentes, etc. Sin embargo, aún existen muchos aspectos que se deben analizar. Uno de ellos es entender los conceptos del optimismo, del tipo de liderazgo y las diferencias culturales de diversos países. Por otro lado, no hay evidencia precisa de la repercusión que tiene el tipo de liderazgo en los seguidores según la cultura presente, que permita comprender las relaciones existentes entre estas variables. Este texto que se presenta se basa en una revisión conceptual de los diferentes tipos de liderazgo; transaccional y transformacional, de la psicología positiva, del capital psicológico y del optimismo. Así mismo, presenta los diferentes estudios que se han realizado acerca de la relación que existe entre el liderazgo y el optimismo generado en los empleados para lograr mayores y mejores resultados, y una relación del liderazgo en diferentes culturas con poca distancia cultural frente a Colombia.

Análisis de la ayuda oficial al desarrollo. estudio de caso: programa conjunto de UNICEF y UNFPA sobre la mutilación genital femenina en Kenia (2008-2012)

El interés de este estudio de caso es analizar el Programa Conjunto de UNFPA y UNICEF sobre MGF/E en Kenia bajo la luz de los postulados poscolonialistas. Partiendo de la idea de que la MGF es una manifestación de las desigualdades de género, se argumenta que el PC reproduce la imagen de la mujer keniana como una víctima del poder masculino. A partir de esta imagen se deslegitima el orden cultural de los grupos que siguen esta tradición, afectando las lógicas de unidad y cohesión de la sociedad. El análisis de este tipo de dinámicas permite comprender mejor los procesos de intervención de las organizaciones internacionales sobre las estructuras sociales de actores frágiles del sistema internacional.

2007-2026 Global market forecast : Airbus

The main drivers of tomorrow's traffic growth - Growing Middle East passenger and cargo hubs - Asia: a new economic paradigm in the making - LCCs in Asia growing in number and traffic share - Accelerating deregulation in Asia - Continuing high growth rate for domestic China and emerging China international outbound traffic.

Global Acceleration and Dispossesion: Regression in the Right to Life and Public Health during Ecuador’s Neoliberal Decades

The present essay’s central argument or hypothesis is, consequently, that the mechanisms accelerating a wealth concentrating and exclusionary economy centred on the benefit and overprotection of big business—with a corresponding plundering of resources that are vital for life—generated forms of loss and regression in the right to healthcare and the dismantling of institutional protections. These are all expressed in indicators from 1990-2005, which point not only to the deterioration of healthcare programs and services but also to the undermining of the general conditions of life (social reproduction) and, in contrast to the reports and predictions of the era’s governments, a stagnation or deterioration in health indicators, especially for those most sensitive to the crisis. The present study’s argument is linked together across distinct chapters. First, we undertake the necessary clarification of the categories central to the understanding of a complex issue; clarifying the concept of health itself and its determinants, emphasizing the necessity of taking on an integral understanding as a fundamental prerequisite to unravelling what documents and reports from this era either leave unsaid or distort. Based on that analysis, we will explain the harmful effects of global economic acceleration, the monopolization and pillaging of strategic healthcare goods; not only those which directly place obstacles on the access to health services, but also those like the destructuration of small economies, linked to the impoverishment and worsening of living modes. Thinking epidemiologically, we intend to show signs of the deterioration of broad collectivities’ ways of life as a result of the mechanisms of acceleration and pillage. We will then collect disparate evidence of the deterioration of human health and ecosystems to, finally, establish the most urgent conclusions about this unfortunate period of our social and medical history.

The turnover of organic carbon in subsoils. Part 2. Modelling carbon turnover

A new model, RothPC-1, is described for the turnover of organic C in the top metre of soil. RothPC-1 is a version of RothC-26.3, an earlier model for the turnover of C in topsoils. In RothPC-1 two extra parameters are used to model turnover in the top metre of soil: one, p, which moves organic C down the profile by an advective process, and the other, s, which slows decomposition with depth. RothPC-1 is parameterized and tested using measurements (described in Part 1, this issue) of total organic C and radiocarbon on soil profiles from the Rothamsted long-term field experiments, collected over a period of more than 100 years. RothPC-1 gives fits to measurements of organic C and radiocarbon in the 0-23, 23-46, 46-69 and 69-92 cm layers of soil that are almost all within (or close to) measurement error in two areas of regenerating woodland (Geescroft and Broadbalk Wildernesses) and an area of cultivated land from the Broadbalk Continuous Wheat Experiment. The fits to old grassland (the Park Grass Experiment) are less close. Two other sites that provide the requisite pre- and post-bomb data are also fitted; a prairie Chernozem from Russia and an annual grassland from California. Roth-PC-1 gives a close fit to measurements of organic C and radiocarbon down the Chernozem profile, provided that allowance is made for soil age; with the annual grassland the fit is acceptable in the upper part of the profile, but not in the clay-rich Bt horizon below. Calculations suggest that treating the top metre of soil as a homogeneous unit will greatly overestimate the effects of global warming in accelerating the decomposition of soil C and hence on the enhanced release of CO2 from soil organic matter; more realistic estimates will be obtained from multi-layer models such as RothPC-1.

Perception and modification of plant flavonoid signals by rhizosphere microorganisms

Flavonoids are a diverse class of polyphenolic compounds that are produced as a result of plant secondary metabolism. They are known to play a multifunctional role in rhizospheric plant-microbe and plant-plant communication. Most familiar is their function as a signal in initiation of the legume-rhizobia symbiosis, but, flavonoids may also be signals in the establishment of arbuscular mycorrhizal symbiosis and are known agents in plant defence and in allelopathic interactions. Flavonoid perception by, and impact on, their microbial targets (e.g. rhizobia, plant pathogens) is relatively well characterized. However, potential impacts on 'non-target' rhizosphere inhabitants ('non-target' is used to distinguish those microorganisms not conventionally known as targets) have not been thoroughly investigated. Thus, this review first summarizes the conventional roles of flavonoids as nod gene inducers, phytoalexins and allelochemicals before exploring questions concerning 'non-target' impacts. We hypothesize that flavonoids act to shape rhizosphere microbial community structure because they represent a potential source of carbon and toxicity and that they impact on rhizosphere function, for example, by accelerating the biodegradation of xenobiotics. We also examine the reverse question, 'how do rhizosphere microbial communities impact on flavonoid signals?' The presence of microorganisms undoubtedly influences the quality and quantity of flavonoids present in the rhizosphere, both through modification of root exudation patterns and microbial catabolism of exudates. Microbial alteration and attenuation of flavonoid signals may have ecological consequences for below-ground plant-microbe and plant-plant interaction. We have a lack of knowledge concerning the composition, concentration and bioavailability of flavonoids actually experienced by microbes in an intact rhizosphere, but this may be addressed through advances in microspectroscopic and biosensor techniques. Through the use of plant mutants defective in flavonoid biosynthesis, we may also start to address the question of the significance of flavonoids in shaping rhizosphere community structure and function.

Enhancement of germination of spores of Verticillium dahliae and Fusarium oxysporum esp vasinfectum in vascular fluid from cotton plants infected with the root-knot nematode

Root-knot nematode [RKN] (Meloidogyne incognita) can increase the severity of Verticillium (V dahliae) and Fusarium (F oxysporum f.sp. vasinfectum) wilt diseases in cotton (Gossypium hirsutum). This study was conducted to determine some of the physiological responses caused by nematode invasion that might decrease resistance to vascular wilt diseases. The effect of RKN was investigated on spore germination and protein, carbohydrate and peroxidase content in the xylem fluids extracted from nematode-infected plants. Two cotton cultivars were used with different levels of resistance to both of the wilt pathogens. Spore germination was greater in the xylem fluids from nematode-infected plants than from nematode-free plants. The effect on spore germination was greater in the Fusarium-resistant cultivar (51%). Analysis of these fluids showed a decrease in total protein and carbohydrate levels for both wilt-resistant cultivars, and an increase in peroxidase concentration. Fluids from nematode-free plants of the Verticillium-resistant cultivar contained 46% more peroxidase than the Fusarium-resistant cultivar. The results provide further evidence that the effect of RKN on vascular wilt resistance is systemic and not only local. Changes in metabolites in the xylem pass from the root to the stem, accelerating disease development.

Winter wheat in England and Wales, 1923 - 1995: What do indices of genetic diversity reveal?

Genealogical data have been used very widely to construct indices with which to examine the contribution of plant breeding programmes to the maintenance and enhancement of genetic resources. In this paper we use such indices to examine changes in the genetic diversity of the winter wheat crop in England and Wales between 1923 and 1995. We find that, except for one period characterized by the dominance of imported varieties, the genetic diversity of the winter wheat crop has been remarkably stable. This agrees with many studies of plant breeding programmes elsewhere. However, underlying the stability of the winter wheat crop is accelerating varietal turnover without any significant diversification of the genetic resources used. Moreover, the changes we observe are more directly attributable to changes in the varietal shares of the area under winter wheat than to the genealogical relationship between the varieties sown. We argue, therefore, that while genealogical indices reflect how well plant breeders have retained and exploited the resources with which they started, these indices suffer from a critical limitation. They do not reflect the proportion of the available range of genetic resources which has been effectively utilized in the breeding programme: complex crosses of a given set of varieties can yield high indices, and yet disguise the loss (or non-utilization) of a large proportion of the available genetic diversity.

Can the study of natural vegetation succession assist in the control of soil erosion on abandoned croplands on the Loess Plateau, China?

In the Loess Plateau, China, arable cultivation of slope lands is common and associated with serious soil erosion. Planting trees or grass may control erosion, but planted species may consume more soil water and can threaten long-term ecosystem sustainability. Natural vegetation succession is an alternative ecological solution to restore degraded land, but there is a time cost, given that the establishment of natural vegetation, adequate to prevent soil erosion, is a longer process than planting. The aims of this study were to identify the environmental factors controlling the type of vegetation established on abandoned cropland and to identify candidate species that might be sown soon after abandonment to accelerate vegetation succession and establishment of natural vegetation to prevent soil erosion. A field survey of thirty-three 2 × 2–m plots was carried out in July 2003, recording age since abandonment, vegetation cover, and frequency of species together with major environmental and soil variables. Data were analyzed using correspondence analysis, classification tree analysis, and species response curves. Four vegetation types were identified and the data analysis confirmed the importance of time since abandonment, total P, and soil water in controlling the type of vegetation established. Among the dominant species in the three late-successional vegetation types, the most appropriate candidates for accelerating and directing vegetation succession were King Ranch bluestem (Bothriochloa ischaemum) and Lespedeza davurica (Leguminosae). These species possess combinations of the following characteristics: tolerance of low water and nutrient availability, fibrous root system and strong lateral vegetative spread, and a persistent seed bank.

Temperature-driven proliferation of Tetracapsuloides bryosalmonae in bryozoan hosts portends salmonid declines

Proliferative kidney disease (PKD) is an emerging disease of salmonid fishes. It is provoked by temperature and caused by infective spores of the myxozoan parasite Tetracapsuloides bryosalmonae, which develops in freshwater bryozoans. We investigated the link between PKD and temperature by determining whether temperature influences the proliferation of T bryosalmonae in the bryozoan host Fredericella sultana. Herein we show that increased temperatures drive the proliferation of T bryosalmonae in bryozoans by provoking, accelerating and prolonging the production of infective spores from cryptic stages. Based on these results we predict that PKD outbreaks will increase further in magnitude and severity in wild and farmed salmonids as a result of climate-driven enhanced proliferation in invertebrate hosts, and urge for early implementation of management strategies to reduce future salmonid declines.

Inhibition of coxsackie B virus infection by soluble forms of its receptors: Binding affinities, altered particle formation, and competition with cellular receptors

We previously reported that soluble decay-accelerating factor (DAF) and coxsackievirus-adenovirus receptor (CAR) blocked coxsackievirus 133 (CVB3) myocarditis in mice, but only soluble CAR blocked CVB3-mediated pancreatitis. Here, we report that the in vitro mechanisms of viral inhibition by these soluble receptors also differ. Soluble DAF inhibited virus infection through the formation of reversible complexes with CVB3, while binding of soluble CAR to CVB induced the formation of altered (A) particles with a resultant irreversible loss of infectivity. A-particle formation was characterized by loss of VP4 from the virions and required incubation of CVB3-CAR complexes at 37 degrees C. Dimeric soluble DAF (DAF-Fc) was found to be 125-fold-more effective at inhibiting CVB3 than monomeric DAF, which corresponded to a 100-fold increase in binding affinity as determined by surface plasmon resonance analysis. Soluble CAR and soluble dimeric CAR (CAR-Fc) bound to CVB3 with 5,000- and 10,000-fold-higher affinities than the equivalent forms of DAF. While DAF-Fc was 125-fold-more effective at inhibiting virus than monomeric DAF, complement regulation by DAF-Fc was decreased 4 fold. Therefore, while the virus binding was a cooperative event, complement regulation was hindered by the molecular orientation of DAF-Fc, indicating that the regions responsible for complement regulation and virus binding do not completely overlap. Relative contributions of CVB binding affinity, receptor binding footprint on the virus capsid, and induction of capsid conformation alterations for the ability of cellular DAF and CAR to act as receptors are discussed.

Generation of anti-complement "prodrugs": cleavable reagents for specific delivery of complement regulators to disease sites

Expression of biologically active molecules as fusion proteins with antibody Fc can substantially extend the plasma half-life of the active agent but may also influence function. We have previously generated a number of fusion proteins comprising a complement regulator coupled to Fc and shown that the hybrid molecule has a long plasma half-life and retains biological activity. However, several of the fusion proteins generated had substantially reduced biological activity when compared with the native regulator or regulator released from the Fc following papain cleavage. We have taken advantage of this finding to engineer a prodrug with low complement regulatory activity that is cleaved at sites of inflammation to release active regulator. Two model prodrugs, comprising, respectively, the four short consensus repeats of human decay accelerating factor (CD55) linked to IgG4 Fc and the three NH2-terminal short consensus repeats of human decay accelerating factor linked to IgG2 Fc have been developed. In each, specific cleavage sites for matrix metalloproteinases and/or aggrecanases have been incorporated between the complement regulator and the Fc. These prodrugs have markedly decreased complement inhibitory activity when compared with the parent regulator in vitro. Exposure of the prodrugs to the relevant enzymes, either purified, or in supernatants of cytokine-stimulated chondrocytes or in synovial fluid, efficiently cleaved the prodrug, releasing active regulator. Such agents, having negligible systemic effects but active at sites of inflammation, represent a paradigm for the next generation of anti-C therapeutics.

Plant conservation: old problems, new perspectives

A review is given of the major conceptual changes that have taken place during the last 50 years in our understanding of the nature of plant conservation and of the principal methodological advances in undertaking conservation assessments and actions, largely through the incorporation of tools and techniques from other disciplines. The interrelationships between conservation and sustainable use are considered as well as the impact of the development of the discipline of conservation biology, the effects of the general acceptance of the concept of biodiversity and the practical implications of the implementation of the Convention on Biological diversity. The effect on conservation policy and management of the accelerating loss or conversion of habitats throughout the world and approaches for combating this are discussed.