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In this article, the author explores the relationship between the notions of self-thought, selfrepair and insurgent sensibilities from the praxis of life, represented in the lived experience, giving sense and meaning to the existence of the human condition in its heterogeneous character. The personal appears as an element of restoration of the political and historical condition of excluded subjects in a process of awakening of consciousness. Hence, it exemplifies actions based on everyday existence and experience mediated by a "dream-project" aimed at the dignified realization of life. In sum, elements of everyday reality are presented as a structuring aspect of existence, a place where the creative meaning of life is recreated and reworked in the idea of human restoration. ; En el presente artículo el autor explora la relación de las nociones de pensamiento propio, autorreparación y sensibilidades insurgentes a partir de la praxis de la vida, representadas en la experiencia vivida, dando sentido y significado a la existencia de la condición humana desde su carácter heterogéneo. Lo propio aparece como un elemento de restauración de la condición política e histórica de los sujetos excluidos en un proceso de toma de conciencia. De ahí que ejemplifique la acción basada en la existencia y experiencia cotidiana mediada por un "sueñoproyecto" hacia la realización dignificante de la vida. En suma, se ponen en escena elementos de la realidad cotidiana como aspecto estructurante de la existencia, lugar donde se recrea y reelabora el sentido creativo de la vida en la idea de la restauración humana.

In this article, the author explores the relationship between the notions of self-thought, self-repair and insurgent sensibilities from the praxis of life, represented in the lived experience, giving sense and meaning to the existence of the human condition in its heterogeneous character. The personal appears as an element of restoration of the political and historical condi-tion of excluded subjects in a process of awakening of consciousness. Hence, it exemplifies actions based on everyday existence and experience mediated by a "dream-project" aimed at the dignified realization of life. In sum, elements of everyday reality are presented as a structuring aspect of existence, a place where the creative meaning of life is recreated and reworked in the idea of human restoration. ; En el presente artículo el autor explora la relación de las nociones de pensamiento propio, autorreparación y sensibilidades insurgentes a partir de la praxis de la vida, representadas en la experiencia vivida, dando sentido y significado a la existencia de la condición humana desde su carácter heterogéneo. Lo propio aparece como un elemento de restauración de la condición política e histórica de los sujetos excluidos en un proceso de toma de conciencia. De ahí que ejemplifique la acción basada en la existencia y experiencia cotidiana mediada por un "sueñoproyecto" hacia la realización dignificante de la vida. En suma, se ponen en escena elementos de la realidad cotidiana como aspecto estructurante de la existencia, lugar donde se recrea y reelabora el sentido creativo de la vida en la idea de la restauración humana.

The global COVID-19 pandemic initiated in Ecuador with the patient zero in February 2020 and since more than 40,000 persons have been tested positive to the virus, leaving some 3,500 deceased, while approximately about 10,500 persons above annual average numbers died within March to May. A strict lockdown was applied by mid-March, which resulted to a severe economic crisis in the country. Although during the lockdown occurred a notable decrease in the number of new cases, the spread of the infection was already massive, untechnical, political and economic decisions will certainly lead to continuous wave of infections for months.Objective Our study postulates, that persons who are most likely to be infected during such secondary wave will be people who have already health issues to which we count besides the known ones, especially those who are already suffer by the distribution of volcanic ashes, as such pyroclastic material is known to affect lunges and thyroids.Methods A descriptive ecological study of information related to COVID-19 infection at a national level using official data from the Minister of Public Health and volcanic ash fall by geographical area in Ecuador.Results The mortality rate per canton indicated that those with lower attack rates are the ones with highest mortality rate. For instance, Portovelo (21.3/100,000), Playas (18.4/100,000), Santa Rosa (15.8/100,000), Suscal (15.3/100,000) and Penipe (14.3/100,000) reported the highest mortality rate per 100,000 people. The main distribution of such volcanic material is within the central to northern area of the Highlands and Inter-Andean Valley of Ecuador, due to the analysis of some 7394 satellite images of the last 21 years.Conclusions We conclude that areas with high vulnerabilities are also most susceptible to develop COVID-19. Such areas with their respective populations will be affected above average and shall be protected in particular within the presently starting during possible second wave of infection. ; La pandemia de COVID-19 inició en Ecuador en febrero de 2020. Desde el inicio más de 40 000 personas han sido oficialmente diagnosticadas con el virus, que ha dejado al menos 3 500 fallecidas, mientras que aproximadamente unas 10 500 personas por encima del promedio anual murieron entre marzo y mayo de 2020. A mediados de marzo se aplicó el confinamiento absoluto en el país, lo que provocó una grave crisis económica y social en Ecuador. Aunque el bloqueo produjo una reducción en el número de casos, la infección estaba propagada ya entre la comunidad y los diagnósticos aumentaron notable debido a decisiones políticas y económicas, que, sin lugar a duda, conducirán a oleadas posteriores de infección por incluso meses.Objetivo Nuestro estudio postula que las personas que tienen más probabilidades de infectarse durante dicha ola secundaria serán las personas que ya tengan problemas de salud. A la vez, proponemos que aquellos pobladores que ya están sufriendo por la caída de cenizas volcánicas y flujos piroclásticos pueden tener más riesgo tal como lo describimos en casos relacionados con cáncer de tiroides y ceniza.Métodos Es un estudio ecológico descriptivo de la información relacionada con la infección por COVID-19 a nivel nacional, utilizando datos oficiales de contagio del Ministerio de Salud Pública y caída de cenizas volcánicas por área geográfica en Ecuador.Resultados La tasa de mortalidad por cantón indicó que aquellos con tasas de ataque más bajas son los que tienen la tasa de mortalidad más alta. Por ejemplo, Portovelo (21,3/100.000), Playas (18,4/100.000), Santa Rosa (15,8/100 000), Suscal (15,3/100 000) y Penipe (14,3/100 000) registraron la tasa de mortalidad más alta por cada 100 000 personas. La principal distribución de dicho material volcánico se encuentra dentro de la zona centro-norte de la Sierra y Valle Interandino del Ecuador, debido al análisis de unas 7 394 imágenes satelitales de los últimos 21 años.Conclusiones Concluimos que las áreas con alta vulnerabilidad también son más susceptibles a desarrollar COVID-19. Tales áreas con sus respectivas poblaciones se verán afectadas por encima de la media y estarán protegidas, en particular, dentro del inicio actual durante una posible segunda ola de infección.

International audience ; The global COVID-19 pandemic has shocked the world. Since the virus gave rise to health problems and often ended in deaths, the count of the contagion and the deceased has been an open issue. Such statistics are vital for every nation and even every city or district and suburb as these numbers decide the level of intervention and the subsequent reduction of its given spread. Worldwide data show a mortality rate of around two percent prior to successful vaccination campaigns. However, Ecuador's statistical data indicate an abnormal amount of excess mortality, which is officially denied in each of the studied countries. These numbers have been projected on a monthly basis and exceed up to 300% of the official COVID-19 deaths. In particular, the average mortality rate in Ecuador, prior to and close to the pandemic, has been about 6083.4±234.6, while in the worst month during the sanitary crisis, deaths piled up to 21,000 people, and only 1180 were recognized as deceased by COVID-19. The reasons are widespread but based on an insufficient financed health sector, political incompetence, lack of leadership, and a long-lasting economic crisis. Therefore, premature endings of confinements or lockdowns have contributed to an accelerated contagion and seem to even counteract the vaccination phase, in middle 2021, shortly before excess mortality ceased completely. ; La pandemia mundial de COVID-19 ha conmocionado al mundo. Dado que el virus dio lugar a problemas de salud y, a menudo, terminó en muertes, el recuento del contagio y de fallecimientos ha sido un tema abierto. Estas estadísticas son vitales para cada nación e incluso para cada ciudad o distrito y suburbio, ya que estos números deciden el nivel de intervención y la consiguiente reducción de su extensión dada. Los datos mundiales indican una tasa de mortalidad de alrededor del dos por ciento antes de campañas de vacunación exitosas. Sin embargo, los datos estadísticos de Ecuador indican una cantidad anormal de exceso de mortalidad, que ...

The global COVID-19 pandemic has shocked the world. Since the virus gave rise to health problems and often ended in deaths, the count of the contagion and the deceased has been an open issue. Such statistics are vital for every nation and even every city or district and suburb as these numbers decide the level of intervention and the subsequent reduction of its given spread. Worldwide data show a mortality rate of around two percent prior to successful vaccination campaigns. However, Ecuador's statistical data indicate an abnormal amount of excess mortality, which is officially denied in each of the studied countries. These numbers have been projected on a monthly basis and exceed up to 300% of the official COVID-19 deaths. In particular, the average mortality rate in Ecuador, prior to and close to the pandemic, has been about 6083.4±234.6, while in the worst month during the sanitary crisis, deaths piled up to 21,000 people, and only 1180 were recognized as deceased by COVID-19. The reasons are widespread but based on an insufficient financed health sector, political incompetence, lack of leadership, and a long-lasting economic crisis. Therefore, premature endings of confinements or lockdowns have contributed to an accelerated contagion and seem to even counteract the vaccination phase, in middle 2021, shortly before excess mortality ceased completely. ; La pandemia mundial de COVID-19 ha conmocionado al mundo. Dado que el virus dio lugar a problemas de salud y, a menudo, terminó en muertes, el recuento del contagio y de fallecimientos ha sido un tema abierto. Estas estadísticas son vitales para cada nación e incluso para cada ciudad o distrito y suburbio, ya que estos números deciden el nivel de intervención y la consiguiente reducción de su extensión dada. Los datos mundiales indican una tasa de mortalidad de alrededor del dos por ciento antes de campañas de vacunación exitosas. Sin embargo, los datos estadísticos de Ecuador indican una cantidad anormal de exceso de mortalidad, que oficialmente se niega en ...

Shortages of essential supplies used to prevent, diagnose, and treat COVID-19 have been a global concern, and price speculation and hikes may have negatively influenced access. This study identifies variability in prices of products acquired through government-driven contracts in Ecuador during the early pandemic response, when the highest mortality rates were registered in a single day. Data were obtained from the National Public Procurement Service (SERCOP) database between March 1 and July 31, 2020. A statistical descriptive analysis was conducted to extract relevant measures for commonly purchased products, medical devices, pharmaceutical drugs, and other goods. Among the most frequently purchased products, the greatest amounts were spent on face masks (US$4.5 million), acetaminophen (US$2.2 million), and reverse transcriptase quantitative polymerase chain reaction assay kits (US$1.8 million). Prices varied greatly, depending on each individual contract and on the number of units purchased; some were exceptionally higher than their market value. Compared with 2019, the mean price of medical examination gloves increased up to 1,307%, acetaminophen 500 mg pills, up to 796%, and oxygen flasks, 30.8%. In a context of budgetary constraints that actually required an effective use of available funds, speculative price hikes may have limited patient access to health care and the protection of the general population and health care workers. COVID-19 vaccine allocations to privileged individuals have also been widely reported. Price caps and other forms of regulation, as well as greater scrutiny and transparency of government-driven purchases, and investment in local production, are warranted in Ecuador for improved infectious disease prevention.

Esteban Ortiz-Prado,1–4 Katherine Simbaña,5,6 Lenin Gómez,5,6 Anna M Stewart-Ibarra,4,7 Lisa Scott,8 Gabriel Cevallos-Sierra9 1OneHealth Research Group, Faculty of Medicine, Universidad De Las Americas, Quito, Ecuador; 2Department of Cellular Biology, Physiology and Immunology, Institute of Biomedicine, Universitat de Barcelona, Spain; 3Department of Physiology, Faculty of Medicine "Eugenio Espejo", Universidad Tecnologica Equinoccial, Quito, Ecuador; 4Department of Medicine, College of Medicine, 5Center for Global Health and Translational Science, Upstate Medical University, State University of New York, Syracuse, NY, USA; 6Faculty of Medical Science, School of Medicine, Universidad Central del Ecuador, 7Prometeo Program, SENESCYT, Quito, Ecuador; 8Graduate College of Biomedical Sciences, Western University of Health Sciences, Lebanon, OR, USA; 9School of Public Health, University of Heidelberg, Heidelberg, Germany Objectives: To describe the epidemiology of abortion in Ecuador from 2004 to 2014 and compare the prevalence between the public and the private health care systems.Methods: This is a cross-sectional analysis of the overall mortality and morbidity rate due to abortion in Ecuador, based on public health records and other government databases.Results: From 2004 to 2014, a total of 431,614 spontaneous abortions, miscarriage and other types of abortions were registered in Ecuador. The average annual rate of abortion was 115 per 1,000 live births. The maternal mortality rate was found to be 43 per 100,000 live births.Conclusions: Abortion is a significant and wide-ranging problem in Ecuador. The study supports the perception that in spite of legal restrictions to abortion in Ecuador, women are still terminating pregnancies when they feel they need to do so. The public health system reported >84% of the national overall prevalence. Keywords: clandestine abortion, private vs public health system, misoprostol, therapeutic abortion, metrotexate, misoprostol

In the Americas, The United States of America, Canada, Mexico, and Brazil are the top vaccine producers and the countries with the leading infrastructure for biological manufacturing. The North American countries have the most demanding legislation regulating and controlling these pharmaceuticals' distribution and production. Some Latin American countries rank in the top 20 of worldwide vaccine manufacturers, with Cuba, Brazil, México and Colombia have a self-sufficient vaccine production of 72.7%, 54,2%; 25%; and 7.7%, respectively, of the national vaccine demand. On the other hand, the rest of Latin American countries cannot satisfy their demand for vaccines, and most of their efforts are associated with the distribution within their health systems rather than in transferring technology. Based on this literature review, the results suggest an increasing growth vaccine demand, not only for their growing populations and previously established demand but also for the recently exerted pressure due to the COVID-19 pandemic. Because the American continent has a marked inequality between the hegemonic producers of vaccines, the exporters, and those that depend heavily on importing these products, this could assert technological dependence in countries with rapid population growth and jeopardize the effectiveness of the two vaccination plans.

The growth of COVID-19 pandemic throughout more than 213 countries around the world have put a lot of pressures on governments and health services to try to stop the rapid expansion of the pandemic. During 2009, H1N1 Influenza pandemic, statistical and mathematical methods were used to track how the virus spreads around countries. Most of these models that were developed at the beginning of the XXI century are based on the classical susceptible–infected–recovered (SIR) model developed almost a hundred years ago. The evolution of this model allows us to forecast and compute basic and effective reproduction numbers (R(t) and R(0)), measures that quantify the epidemic potential of a pathogen and estimates different scenarios. In this study, we present a traditional estimation technique for [Formula: see text] with statistical distributions by best fitting and a Bayesian approach based on continuous feed of prior distributions to obtain posterior distributions and computing real time [Formula: see text]. We use data from COVID-19 officially reported cases in Ecuador since the first confirmed case on February 29th. Because of the lack of data, in the case of [Formula: see text] we compare two methods for the estimation of these parameters below exponential growth and maximum likelihood estimation. We do not make any assumption about the evolution of cases due to limited information and we use previous methods to compare scenarios about [Formula: see text] and in the case of [Formula: see text] we used Bayesian inference to model uncertainty in contagious proposing a new modification to the well-known model of Bettencourt and Ribeiro based on a time window of [Formula: see text] days to improve estimations. Ecuadorian [Formula: see text] with exponential growth criteria was 3.45 and with the maximum likelihood estimation method was 2.93. The results show that Guayas, Pichincha and Manabí were the provinces with the highest number of cases due to COVID-19. Some reasons explain the increased transmissibility in these ...

BACKGROUND: As the disease caused by the novel coronavirus has spread globally, there has been significant economic instability in the healthcare systems. This reality was especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors has led Ecuador to face the most aggressive outbreak in Latin America. In this context, the participation of final-year medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent requirement that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes, and practices of Ecuadorian final-year medical students that could potentially guide the design of better medical education curricula regarding COVID-19. METHODS: This was a cross-sectional 33-item online survey conducted between April 6 to April 2020 assessing the knowledge, attitudes, and practices toward the diagnosis, treatment, prevention, and prognosis toward COVID-19 in Ecuadorian final-year medical students. It was sent by email, Facebook, and WhatsApp. RESULTS: A total of 309 students responded to the survey. Out of which 88% of students scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID-19 and volunteering during the outbreak in Ecuador (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment. The latter finding was significantly associated with negative attitudes. CONCLUSIONS: Although a large number of students displayed negative attitudes, the non-depreciable percentage of students who were willing to volunteer and the coexisting high level of knowledge displayed by students, suggests that Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Not having ...

Ammonia, a molecule that is gaining more interest as a fueling vector, has been considered as a candidate to power transport, produce energy, and support heating applications for decades. However, the particular characteristics of the molecule always made it a chemical with low, if any, benefit once compared to conventional fossil fuels. Still, the current need to decarbonize our economy makes the search of new methods crucial to use chemicals, such as ammonia, that can be produced and employed without incurring in the emission of carbon oxides. Therefore, current efforts in this field are leading scientists, industries, and governments to seriously invest efforts in the development of holistic solutions capable of making ammonia a viable fuel for the transition toward a clean future. On that basis, this review has approached the subject gathering inputs from scientists actively working on the topic. The review starts from the importance of ammonia as an energy vector, moving through all of the steps in the production, distribution, utilization, safety, legal considerations, and economic aspects of the use of such a molecule to support the future energy mix. Fundamentals of combustion and practical cases for the recovery of energy of ammonia are also addressed, thus providing a complete view of what potentially could become a vector of crucial importance to the mitigation of carbon emissions. Different from other works, this review seeks to provide a holistic perspective of ammonia as a chemical that presents benefits and constraints for storing energy from sustainable sources. State-of-the-art knowledge provided by academics actively engaged with the topic at various fronts also enables a clear vision of the progress in each of the branches of ammonia as an energy carrier. Further, the fundamental boundaries of the use of the molecule are expanded to real technical issues for all potential technologies capable of using it for energy purposes, legal barriers that will be faced to achieve its deployment, safety ...