LA INEQUIDAD EN EL CAMPO DE LA SALUD PUBLICA EN AMERICA LATINA: UNA CUESTION CRUCIAL

América Latina es considerada la región más desigual del planeta. Es el Continente donde, según múltiples fuentes, las polarizaciones son mayores en diversos campos, y el acceso a las oportunidades es marcadamente disímil para los diferentes sectores sociales. ¿Cómo impacta la inequidad latinoamericana el fundamental campo de la salud? ¿Qué problemas determina en esta área decisiva de la vida de las sociedades, y qué obstáculos y trabas pone al avance de los esfuerzos para mejorar la salud?.A pesar de su clara relevancia, este tema ha sido limitadamente puesto a foco. El objetivo de este trabajo es llamar la atención sobre el mismo, y contribuir a estimular este debate tan necesario. Para ello se subraya, en primer término, el papel central de la salud para el desarrollo, se reseñan las amplias brechas que existen, a pesar de ello, a nivel mundial entre países, y a su interior, se encaran ciertos difundidos mitos sobre cómo superar los problemas en salud, se exploran algunos de los principales impactos de la desigualdad de América Latina sobre aspectos básicos del campo de la salud y, finalmente, se sugieren algunas líneas de la gran tarea por realizar para enfrentar el peso de la inequidad sobre la salud pública.

LA DEUDA PUBLICA INTERNA EN COSTA RICA

El déficit fiscal es una de las variables macroeconómicas que ha adquirido mayor importancia desde la década de los años ochenta y particularmente en los años noventa, en la economía costarricense. Una consecuencia directa de la existencia de déficits fiscales sostenidos es la acumulación de una deuda pública creciente.Antes de los años ochenta el déficit fiscal en Costa Rica se cubrió fundamentalmente con deduda externa; la cual era de fácil acceso en los mercados financieros internacionales, ante la existencia de una sobre oferta de fondos prestables, generado por los petrodólares. Sin embargo, con la crisis económica que experimentó Costa Rica en los primeros años de la década pasada y con el endurecimiento del acceso al financiamiento externo, el país empezó a recurrir cada vez con más frecuencia al endeudamiento interno.

Soil characteristics in Doon Valley (north west Himalaya, India) by inversion of H/V spectral ratios from ambient noise measurements

Past and recent observations have shown that the local site conditions significantly affect the behavior of seismic waves and its potential to cause destructive earthquakes. Thus, seismic microzonation studies have become crucial for seismic hazard assessment, providing local soil characteristics that can help to evaluate the possible seismic effects. Among the different methods used for estimating the soil characteristics, the ones based on ambient noise measurements, such as the H/V technique, become a cheap, non-invasive and successful way for evaluating the soil properties along a studied area. In this work, ambient noise measurements were taken at 240 sites around the Doon Valley, India, in order to characterize the sediment deposits. First, the H/V analysis has been carried out to estimate the resonant frequencies along the valley. Subsequently, some of this H/V results have been inverted, using the neighborhood algorithm and the available geotechnical information, in order to provide an estimation of the S-wave velocity profiles at the studied sites. Using all these information, we have characterized the sedimentary deposits in different areas of the Doon Valley, providing the resonant frequency, the soil thickness, the mean S-wave velocity of the sediments, and the mean S-wave velocity in the uppermost 30 m.

AMPLITUDE-VERSUS-ANGLE ANALYSIS AND WIDE-ANGLE-INVERSION OF CROSSWELL SEISMIC DATA IN A CARBONATE RESERVOIR

Crosswell data set contains a range of angles limited only by the geometry of the source and receiver configuration, the separation of the boreholes and the depth to the target. However, the wide angles reflections present in crosswell imaging result in amplitude-versus-angle (AVA) features not usually observed in surface data. These features include reflections from angles that are near critical and beyond critical for many of the interfaces; some of these reflections are visible only for a small range of angles, presumably near their critical angle. High-resolution crosswell seismic surveys were conducted over a Silurian (Niagaran) reef at two fields in northern Michigan, Springdale and Coldspring. The Springdale wells extended to much greater depths than the reef, and imaging was conducted from above and from beneath the reef. Combining the results from images obtained from above with those from beneath provides additional information, by exhibiting ranges of angles that are different for the two images, especially for reflectors at shallow depths, and second, by providing additional constraints on the solutions for Zoeppritz equations. Inversion of seismic data for impedance has become a standard part of the workflow for quantitative reservoir characterization. Inversion of crosswell data using either deterministic or geostatistical methods can lead to poor results with phase change beyond the critical angle, however, the simultaneous pre-stack inversion of partial angle stacks may be best conducted with restrictions to angles less than critical. Deterministic inversion is designed to yield only a single model of elastic properties (best-fit), while the geostatistical inversion produces multiple models (realizations) of elastic properties, lithology and reservoir properties. Geostatistical inversion produces results with far more detail than deterministic inversion. The magnitude of difference in details between both types of inversion becomes increasingly pronounced for thinner reservoirs, particularly those beyond the vertical resolution of the seismic. For any interface imaged from above and from beneath, the results AVA characters must result from identical contrasts in elastic properties in the two sets of images, albeit in reverse order. An inversion approach to handle both datasets simultaneously, at pre-critical angles, is demonstrated in this work. The main exploration problem for carbonate reefs is determining the porosity distribution. Images of elastic properties, obtained from deterministic and geostatistical simultaneous inversion of a high-resolution crosswell seismic survey were used to obtain the internal structure and reservoir properties (porosity) of Niagaran Michigan reef. The images obtained are the best of any Niagaran pinnacle reef to date.

VALIDATION OF A 'DISPLACEMENT TOMOGRAPHY' INVERSION METHOD FOR MODELING SHEET INTRUSIONS

The study of volcano deformation data can provide information on magma processes and help assess the potential for future eruptions. In employing inverse deformation modeling on these data, we attempt to characterize the geometry, location and volume/pressure change of a deformation source. Techniques currently used to model sheet intrusions (e.g., dikes and sills) often require significant a priori assumptions about source geometry and can require testing a large number of parameters. Moreover, surface deformations are a non-linear function of the source geometry and location. This requires the use of Monte Carlo inversion techniques which leads to long computation times. Recently, ‘displacement tomography’ models have been used to characterize magma reservoirs by inverting source deformation data for volume changes using a grid of point sources in the subsurface. The computations involved in these models are less intensive as no assumptions are made on the source geometry and location, and the relationship between the point sources and the surface deformation is linear. In this project, seeking a less computationally intensive technique for fracture sources, we tested if this displacement tomography method for reservoirs could be used for sheet intrusions. We began by simulating the opening of three synthetic dikes of known geometry and location using an established deformation model for fracture sources. We then sought to reproduce the displacements and volume changes undergone by the fractures using the sources employed in the tomography methodology. Results of this validation indicate the volumetric point sources are not appropriate for locating fracture sources, however they may provide useful qualitative information on volume changes occurring in the surrounding rock, and therefore indirectly indicate the source location.

Reassessing the Evolutionary History of the 17q21 Inversion Polymorphism

A polymorphic inversion that lies on chromosome 17q21 comprises two major haplotype families (H1 and H2) that not only differ in orientation but also in copy-number. Although the processes driving the spread of the inversion-associated lineage (H2) in humans remain unclear, a selective advantage has been proposed for one of its subtypes. Here, we genotyped a large panel of individuals from previously overlooked populations using a custom array with a unique panel of H2-specific single nucleotide polymorphisms and found a patchy distribution of H2 haplotypes in Africa, with North Africans displaying a higher frequency of inverted subtypes, when compared with Sub-Saharan groups. Interestingly, North African H2s were found to be closer to "non-African" chromosomes further supporting that these populations may have diverged more recently from groups outside Africa. Our results uncovered higher diversity within the H2 family than previously described, weakening the hypothesis of a strong selective sweep on all inverted chromosomes and suggesting a rather complex evolutionary history at this locus.

A qualitative impairment in face perception in Alzheimer’s disease : evidence from a reduced face inversion effect

Prevalent face recognition difficulties in Alzheimer’s disease (AD) have typically been attributed to the underlying episodic and semantic memory impairment. The aim of the current study was to determine if AD patients are also impaired at the perceptual level for faces, more specifically at extracting a visual representation of an individual face. To address this question, we investigated the matching of simultaneously presented individual faces and of other nonface familiar shapes (cars), at both upright and inverted orientation, in a group of mild AD patients and in a group of healthy older controls matched for age and education. AD patients showed a reduced inversion effect (i.e., larger performance for upright than inverted stimuli) for faces, but not for cars, both in terms of error rates and response times. While healthy participants showed a much larger decrease in performance for faces than for cars with inversion, the inversion effect did not differ significantly for faces and cars in AD. This abnormal inversion effect for faces was observed in a large subset of individual patients with AD. These results suggest that AD patients have deficits in higher-level visual processes, more specifically at perceiving individual faces, a function that relies on holistic representations specific to upright face stimuli. These deficits, combined with their memory impairment, may contribute to the difficulties in recognizing familiar people that are often reported in patients suffering from the disease and by their caregivers.

Conceptos y prácticas de la actividad física que se reproducen en las clases sociales: aproximación desde el enfoque determinantes/ determinación social de la salud

El concepto de actividad física es concebido de diferentes formas. Mostrando que existen varios factores que afectan de manera directa e indirecta la percepción que los sujetos construyen entorno a él, generando así una aproximación a diferentes definiciones de la actividad física desde varias perspectivas y dimensiones, donde predomina una noción netamente biológica. Este estudio pretende analizar, como desde las clases sociales se concibe la actividad física en sus conceptos y prácticas considerando los modelos de determinantes y determinación social para la salud. Con fin de comprender como los autores de la literatura científica conciben la actividad física y la relación con las clases sociales, desde una perspectiva teórica de los determinantes sociales de la salud y la teoría de la determinación social, se realizó una revisión documental y análisis de contenido de los conceptos y prácticas de la actividad física que se han considerado en los últimos 10 años. Para ello se seleccionaron las bases de datos PubMed y BVS (Biblioteca Virtual de Salud) por sus énfasis en publicaciones de salud mundialmente. Mostrando que la actividad física es concebida dominantemente desde una perspectiva biológica que ejerce una mirada reduccionista. Las relaciones entre actividad física y las clases sociales están claramente establecidas, sin embargo, estas relaciones pueden discrepar teniendo en cuenta el concepto de clase social, el contexto y la orientación de los autores y las poblaciones objetos de estudio. Obteniendo como resultado que los estudios documentados, revisados y analizados muestran una clara tendencia al modelo de determinantes; no obstante, algunos estudios en sus análisis se orientan hacia el modelo de determinación social. En cuanto al concepto de clases sociales los autores consideran una combinación de factores culturales y económicos sin atreverse a adoptar un concepto específico.

Principios de la actividad electoral en la era digital : una aproximación al control administrativo colombiano de la propaganda electoral en Internet

El desarrollo tecnológico y la expansión de las formas de comunicación en Colombia, no solo trajeron consigo grandes beneficios, sino también nuevos retos para el Estado Moderno. Actualmente, la oferta de espacios de difusión de propaganda electoral ha aumentado, mientras persiste un marco legal diseñado para los medios de comunicación del Siglo XX. Por tanto, este trabajo no solo realiza un diagnóstico de los actuales mecanismos de control administrativo sobre la propaganda electoral en Internet, sino también propone unos mecanismos que garanticen los principios de la actividad electoral, siendo esta la primera propuesta en Colombia. Por el poco estudio del tema, su alcance es exploratorio, se basa en un enfoque jurídico-institucional. Se utilizaron métodos cualitativos de recolección de datos (trabajo de archivo y entrevistas) y de análisis (tipologías, comparaciones, exegesis del marco legal), pero también elementos cuantitativos como análisis estadísticos.

Inversion of ambient seismic noise HVSR to evaluate velocity and structural models of the Lower Tagus Basin, Portugal

During its history, several significant earthquakes have shaken the Lower Tagus Valley (Portugal). These earthquakes were destructive; some strong earthquakes were produced by large ruptures in offshore structures located southwest of the Portuguese coastline, and other moderate earthquakes were produced by local faults. In recent years, several studies have successfully obtained strong-ground motion syntheses for the Lower Tagus Valley using the finite difference method. To confirm the velocity model of this sedimentary basin obtained from geophysical and geological data, we analysed the ambient seismic noise measurements by applying the horizontal to vertical spectral ratio (HVSR) method. This study reveals the dependence of the frequency and amplitude of the low-frequency (HVSR) peaks (0.2–2 Hz) on the sediment thickness. We have obtained the depth of the Cenozoic basement along a profile transversal to the basin by the inversion of these ratios, imposing constraints from seismic reflection, boreholes, seismic sounding and gravimetric and magnetic potentials. This technique enables us to improve the existing three-dimensional model of the Lower Tagus Valley structure. The improved model will be decisive for the improvement of strong motion predictions in the earthquake hazard analysis of this highly populated basin. The methodology discussed can be applied to any other sedimentary basin.

Subsidence history, thermal maturity, and structural inversion of the Greater Caucasus-Kura-Adjara-Trialeti basin system of central-eastern Georgia

This study aims at defining the tectonic evolution of a portion of the Caucasian region, in Georgia, which experienced a complex pattern of deformation events throughout Mesozoic and Cenozoic times. An integrated approach was applied to unravel the thermo-tectonic history of three inverted sedimentary basins from burial to exhumation. Additionally, this dissertation provides examples of structural inversion of sedimentary basins in response to far-field transmission of compressional stresses away from collision zones, contributing to elucidate the dynamics of stress partitioning during continental collisions. The Adjara-Trialeti fold-and-thrust belt in south-western Georgia results from the structural inversion of a Middle Eocene continental back-arc rift basin opened as a consequence of the Northern Neotethys slab rollback. This study quantitatively defines the subsidence and exhumation history of the Adjara-Trialeti basin, constraining its Middle Miocene inception of structural inversion. The western Kura Basin is a flexural foreland basin trapped between the Lesser Caucasus to the south and the Greater Caucasus to the north. This study constrains successive and competing episodes of flexural subsidence during Oligocene-Miocene times, followed by partial inversion through thick- and thin-skinned tectonics in response to continued convergence between the adjacent, oppositely verging orogenic belts. The Greater Caucasus results from the structural inversion of a Jurassic continental back-arc basin, but the timing of its growth is still debated. An across-strike transect in its southern central domain was studied, indicating that this sector of the Greater Caucasus experienced two phases of structural inversion during Late Cretaceous-Paleocene and Late Miocene times. Overall, the dataset presented in this dissertation points to a complex and episodic history of incremental deformation, characterised by successive phases of extensional and compressional tectonics which developed in response to sequential terrane accretion at the southwestern margin of Eurasia since Late Cretaceous times, eventually determining the current configuration of the Arabia-Eurasia collision zone.

A Trans-dimensional inversion algorithm to model deformation sources with unconstrained shape in finite element domains

Ground deformation provides valuable insights on subsurface processes with pattens reflecting the characteristics of the source at depth. In active volcanic sites displacements can be observed in unrest phases; therefore, a correct interpretation is essential to assess the hazard potential. Inverse modeling is employed to obtain quantitative estimates of parameters describing the source. However, despite the robustness of the available approaches, a realistic imaging of these reservoirs is still challenging. While analytical models return quick but simplistic results, assuming an isotropic and elastic crust, more sophisticated numerical models, accounting for the effects of topographic loads, crust inelasticity and structural discontinuities, require much higher computational effort and information about the crust rheology may be challenging to infer. All these approaches are based on a-priori source shape constraints, influencing the solution reliability. In this thesis, we present a new approach aimed at overcoming the aforementioned limitations, modeling sources free of a-priori shape constraints with the advantages of FEM simulations, but with a cost-efficient procedure. The source is represented as an assembly of elementary units, consisting in cubic elements of a regular FE mesh loaded with a unitary stress tensors. The surface response due to each of the six stress tensor components is computed and linearly combined to obtain the total displacement field. In this way, the source can assume potentially any shape. Our tests prove the equivalence of the deformation fields due to our assembly and that of corresponding cavities with uniform boundary pressure. Our ability to simulate pressurized cavities in a continuum domain permits to pre-compute surface responses, avoiding remeshing. A Bayesian trans-dimensional inversion algorithm implementing this strategy is developed. 3D Voronoi cells are used to sample the model domain, selecting the elementary units contributing to the source solution and those remaining inactive as part of the crust.

Synthetic generation of amyloid PET images by non-linear dimensionality reduction inversion

Privacy issues and data scarcity in PET field call for efficient methods to expand datasets via synthetic generation of new data that cannot be traced back to real patients and that are also realistic. In this thesis, machine learning techniques were applied to 1001 amyloid-beta PET images, which had undergone a diagnosis of Alzheimer’s disease: the evaluations were 540 positive, 457 negative and 4 unknown. Isomap algorithm was used as a manifold learning method to reduce the dimensions of the PET dataset; a numerical scale-free interpolation method was applied to invert the dimensionality reduction map. The interpolant was tested on the PET images via LOOCV, where the removed images were compared with the reconstructed ones with the mean SSIM index (MSSIM = 0.76 ± 0.06). The effectiveness of this measure is questioned, since it indicated slightly higher performance for a method of comparison using PCA (MSSIM = 0.79 ± 0.06), which gave clearly poor quality reconstructed images with respect to those recovered by the numerical inverse mapping. Ten synthetic PET images were generated and, after having been mixed with ten originals, were sent to a team of clinicians for the visual assessment of their realism; no significant agreements were found either between clinicians and the true image labels or among the clinicians, meaning that original and synthetic images were indistinguishable. The future perspective of this thesis points to the improvement of the amyloid-beta PET research field by increasing available data, overcoming the constraints of data acquisition and privacy issues. Potential improvements can be achieved via refinements of the manifold learning and the inverse mapping stages during the PET image analysis, by exploring different combinations in the choice of algorithm parameters and by applying other non-linear dimensionality reduction algorithms. A final prospect of this work is the search for new methods to assess image reconstruction quality.

Mucopolysaccharidosis Type Ii: Identification Of 30 Novel Mutations Among Latin American Patients.

In this study, 103 unrelated South-American patients with mucopolysaccharidosis type II (MPS II) were investigated aiming at the identification of iduronate-2-sulfatase (IDS) disease causing mutations and the possibility of some insights on the genotype-phenotype correlation The strategy used for genotyping involved the identification of the previously reported inversion/disruption of the IDS gene by PCR and screening for other mutations by PCR/SSCP. The exons with altered mobility on SSCP were sequenced, as well as all the exons of patients with no SSCP alteration. By using this strategy, we were able to find the pathogenic mutation in all patients. Alterations such as inversion/disruption and partial/total deletions of the IDS gene were found in 20/103 (19%) patients. Small insertions/deletions/indels (<22 bp) and point mutations were identified in 83/103 (88%) patients, including 30 novel mutations; except for a higher frequency of small duplications in relation to small deletions, the frequencies of major and minor alterations found in our sample are in accordance with those described in the literature.