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Although CE in other settings, trastuzumab was not CE in LA. The use of health technology assessment to prioritize resource allocation and support price negotiations is critical to making innovative drugs available and affordable in developing countries.

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The study and analysis of precipitation has become a crucial tool in understanding the temporal and spatial behavior of water resources, in terms of availability and impact on extreme events. The objective of this study was to evaluate different rainfall parameters (intensities for 1-h duration D = 1 h and return periods of T = 5 and 100 yr, and mean annual precipitation) for different latitudinal and climatic zones in Chile. We analyzed the information recorded on thousands of pluvial bands and rain gauges for 49 stations; this because it is unclear how rainfall intensities change along the country (though total amounts do), in addition to a lack of literature focused on ranges and amounts on the behavior of rainfall variables. The Gumbel probability distribution function (PDF) and mathematical rainfall intensity formulas were used to develop intensity-duration-frequency (IDF) curves for each station. Maximum and minimum rainfall intensity values for T = 100 yr ranged from 8.79 (hyperarid zone) to 40.17 mm h -1 (subhumid-humid zone). Total annual rainfall values ranged between 43.9 (hyperarid zone) and 3891.0 mm yr -1 (humid zone). Additionally, the real maximum intensity registered on each station was analyzed, determining its exceedance probability. Likewise, multiple comparisons were made to detect significant differences between the gauge stations and different climatic zones using the Kruskal Wallis test (alpha = 0.05). Differences between maximum and minimum values registered for all stations were as much as 80 times for total rainfall amounts and 4.5 times for rainfall intensities (T = 100 yr). However, maximum rainfall intensities values were similar at different latitudes, suggesting the absence of correlation between maximum rainfall intensity and annual rainfall amount, as the latter variable increased gradually with latitude.

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RESUMENObjetivo: Comprender los factores relacionados con el embarazo no planificado en las adolescentes, desde la perspectiva de las escolares nuligestas. Método: Estudio cualitativo de casos, en mujeres entre 15 y 19 años, pertenecientes a dos establecimientos educacionales, con altos índices de embarazo, en la ciudad de Temuco, Chile. Se realizaron cuatro grupos focales, constituidos por 14 adolescentes no embarazadas, identificándose factores en las dimensiones individuales, familiares y sociales. Para el análisis se utilizó el programa ATLAS-ti 4,1. Se trianguló por investigador en la ejecución del estudio y análisis de los datos. Resultados: En la dimensión individual aparecen como relevantes factores de riesgo que favorecen el embarazo (FFE): "amor romántico", no uso de métodos anticonceptivos, baja autoestima, irresponsabilidad masculina y falta de conocimiento en sexualidad. En la dimensión familiar destacan los factores: límite estrecho familiar y negligencia paterna. Surgen factores percibidos por las adolescentes como protectoras del embarazo no planificado (FPE), en la dimensión individual destacan: capacidad reflexiva y proyecto de vida; en la dimensión familiar: "familia cuidadora" y límites claros; y en la dimensión social la categoría o factor con mayor peso es "sanción social". Conclusiones: Entre los hallazgos destacan como FFE relevantes el "amor romántico" y los límites polares familiares. Como FPE, la capacidad de reflexión y "familia cuidadora". Estos elementos debieran ser considerados en la prevención del embarazo no planificado en población adolescente. PALABRAS CLAVE: Factores asociados, embarazo no planificado, embarazo en adolescencia SUMMARYObjective: To identify and understand factors associated to pregnancy in adolescents under the perspective of the never pregnant adolescent. Methods: Qualitative study undergone on women 15 to 19 years of age. School based sample of women were drawn from 2 schools chosen due to their high pregnancy rate. Four focus groups were created and each one was composed by 14 eligible women. Factors associated to individuals, to family, and to social environment were studied. Triangulation was performed during the study conduction and data analysis. Analysis was done by using ATLAS-ti 4.1. Results: Factors which appear to be favouring pregnancy at the individuals were: "romantic love", no use of contraceptives, low self esteem, male irresponsibility, lack of knowledge in sexuality. At the family level, the factors are: the permit's restriction

An extra-heavy crude oil underground upgrading process is described which involves the downhole addition of a hydrogen donor additive (tetralin) under steam injection conditions. Using a batch laboratory reactor or a continuous bench scale plant (280–315°C and residence times between 24–64 h), physical simulation experiments showed an increase of at least 3° in API gravity of the treated Extra-Heavy Crude Oil, three-fold viscosity reduction and, approximately, 8% decrease in the asphaltene content with respect to the original crude. It was found that the presence of the natural formation (catalyst) and methane (natural gas) is necessary to enhance the properties of the upgraded crude oil. Compositional-thermal numerical simulations were carried out and the results showed a good match between the calculated and experimental °API gravities of the upgraded crude oil (average relative error 1–4%) for all conditions studied. Similar results were obtained with the asphaltene contents (14–23%), percentage of conversion of the >500°C fraction (12%) and tetralin (16–23%). Introduction Downhole extra-heavy crude oil upgrading processes have high potential value due to the possibility of improving crude oil quality with the concomitant higher benefits obtained by their exploitation. Underground processes leads to several advantages in comparison with aboveground counterparts. First at all, enhanced oil recovery could be obtained by adding additional oil reserves. Also, increase in the volumetric production of wells and lower lifting and transportation costs from the underground to the refining centers could be generated. Finally, the use of porous media (mineral formation) as natural chemical "catalytic reactor" will improve the upgraded crude oil properties with further reductions in expenses during down stream refining operations. Several routes for underground extra-heavy crude oil upgrading have been reported. These concepts involve the following: Physical separations (steam distillation1 or deasphalting2), underground cracking or hydrocracking (visbreaking3–4, hydrogen6 or hydrogen precursor injection6–7) and in situ combustion8–9. In this work, a different concept10 is presented (Fig. 1) involving the underground addition of a hydrogen donor additive (tetralin), which in the presence of steam, natural formation (catalyst) and methane (natural gas), leads to extra-heavy crude oil upgrading. This concept is coupled to a steam stimulation process11 with 70–80% hydrogen donor recycled as depicted in Fig. 1. Specifically, batch reactor and continuous bench scale plant physical simulations are presented under steam injection conditions (280°C, 1600 psi), and crude oil upgrading is measured in terms of its API gravity, viscosity and percentages of asphaltenes. Different extra-heavy crude oils were studied and compositional thermal simulations were carried out in order to model the upgrading process under steam stimulation conditions. Experimental Part The extra-heavy crude oils came from the Orinoco Belt (Hamaca and Cerro Negro) and their properties are listed in Table 1. The percentages of asphaltenes were measured using the ASTM D-3279 and crude oil viscosities in a Brookfield apparatus, model RVTDV-II.

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