Sistema de comisiones de las Administradoras de Fondos de Pensiones en Colombia.

El actual sistema de comisiones en Colombia no genera los incentivos necesarios para que las Administradoras de Fondos de Pensiones (AFP) incrementen la rentabilidad de los fondos de pensiones. Dado que la mesada pensional futura de los afiliados depende principalmente de la capitalización de los aportes, es necesario generar un esquema en el cual las AFP estén incentivadas a incrementar los rendimientos de los fondos. Por medio de un modelo en que se calcula el saldo de capital de un afiliado, en este documento se muestran las ventajas de un esquema de comisiones por rendimientos, y cómo este esquema puede ser combinado con un esquema de comisiones sobre aportes como el actual. Finalmente se señalan algunos aspectos a tener en cuenta a la hora de implementar un esquema en esta dirección.

New RED-type TCP-AQM algorithms based on beta distribution drop functions

In recent years, Active Queue Management (AQM) mechanisms to improve the performance of TCP/IP networks have acquired a relevant role. In this paper we present a simple and robust RED-type algorithm together with a couple of dynamical variants with the ability to adapt to the specific characteristics of different network environments, as well as to the user needs. We first present a basic version called Beta RED (BetaRED), where the user is free to adjust the parameters according to the network conditions. The aim is to make the parameter setting easy and intuitive so that a good performance is obtained over a wide range of parameters. Secondly, BetaRED is used as a framework to design two dynamic algorithms, which we will call Adaptive Beta RED (ABetaRED) and Dynamic Beta RED (DBetaRED). In those new algorithms certain parameters are dynamically adjusted so that the queue length remains stable around a predetermined reference value and according to changing network traffic conditions. Finally, we present a battery of simulations using the Network Simulator 3 (ns-3) software with a two-fold objective: to guide the user on how to adjust the parameters of the BetaRED mechanism, and to show a performance comparison of ABetaRED and DBetaRED with other representative algorithms that pursue a similar objective

Diagnostic yield of early repeat colonoscopy after suboptimal bowel preparation in a fecal immunochemical test-based screening program

Background Current guidelines regarding surveillance after screening colonoscopy assume adequate bowel preparation. However, follow-up intervals after suboptimal cleansing are highly heterogeneous. We aimed to determine the diagnostic yield of early repeat colonoscopy in patients with suboptimal bowel preparation in fecal immunochemical test (FIT)-based screening colonoscopy. Methods An observational study including patients who underwent colonoscopy with suboptimal bowel preparation after positive FIT screening and then repeat colonoscopy within 1 year. Suboptimal preparation was defined as a Boston Bowel Preparation Scale (BBPS) score of 1 in any segment. Patients with a BBPS score of 0 in any segment or incomplete examination were excluded. The adenoma detection rate (ADR), advanced ADR (AADR), and colorectal cancer rate were calculated for the index and repeat colonoscopies. Results Of the 2474 patients with FIT-positive colonoscopy at our center during this period, 314 (12.7%) had suboptimal preparation. Of the 259 (82.5%) patients who underwent repeat colonoscopy, suboptimal cleansing persisted in 22 (9 %). On repeat colonoscopy, the ADR was 38.7% (95% CI 32.6% to 44.8%) and the AADR was 14.9% (95%CI 10.5% to 19.4%). The per-adenoma miss rate was 27.7% (95 %CI 24.0% to 31.6%), and the per-advanced adenoma miss rate was 17.6% (95%CI 13.3% to 22.7%). After repeat colonoscopy, the post-polypectomy surveillance recommendation changed from 10 to 3 years in 14.7% of the patients with previous 10-year surveillance recommendation. Conclusions Patients with suboptimal bowel preparation on FIT-positive colonoscopy present a high rate of advanced adenomas in repeat colonoscopy, with major changes in post-polypectomy surveillance recommendations

Periodogram Connectivity of EEG Signals for the Detection of Dyslexia

Electroencephalography (EEG) signals provide an important source of information of brain activity at different areas. This information can be used to diagnose brain disorders according to different activation patterns found in controls and patients. This acquisition technology can be also used to explore the neural basis of less evident learning disabilities such as Developmental Dyslexia (DD). DD is a specific difficulty in the acquisition of reading skills not related to mental age or inadequate schooling, whose prevalent is estimated between 5% and 12% of the population. In this paper we propose a method to extract discriminative features from EEG signals based on the relationship among the spectral density at each channel. This relationship is computed by means of different correlation measures, inferring connectivity-like markers that are eventually selected and classified by a linear support vector machine. The experiments performed shown AUC values up to 0.7, demonstrating the applicability of the proposed approach for objective DD diagnosis

Dorsolateral prefrontal cortex and amygdala function during cognitive reappraisal predicts weight restoration and emotion regulation impairment in anorexia nervosa

Background: although deficits in affective processing are a core component of anorexia nervosa (AN), we lack a detailed characterization of the neurobiological underpinnings of emotion regulation impairment in AN. Moreover, it remains unclear whether these neural correlates scale with clinical outcomes. Methods: we investigated the neural correlates of negative emotion regulation in a sample of young women receiving day-hospital treatment for AN (n = 21) and healthy controls (n = 21). We aimed to determine whether aberrant brain activation patterns during emotion regulation predicted weight gain following treatment in AN patients and were linked to AN severity. To achieve this, participants completed a cognitive reappraisal paradigm during functional magnetic resonance imaging. Skin conductance response, as well as subjective distress ratings, were recorded to corroborate task engagement. Results: compared to controls, patients with AN showed reduced activation in the dorsolateral prefrontal cortex (dlPFC) during cognitive reappraisal [pFWE<0.05, threshold-free cluster enhancement (TFCE) corrected]. Importantly, psycho-physiological interaction analysis revealed reduced functional connectivity between the dlPFC and the amygdala in AN patients during emotion regulation (pFWE<0.05, TFCE corrected), and dlPFC-amygdala uncoupling was associated with emotion regulation deficits (r = -0.511, p = 0.018) and eating disorder severity (r = -0.565, p = .008) in the AN group. Finally, dlPFC activity positively correlated with increases in body mass index (r = 0.471, p = 0.042) and in body fat mass percentage (r = 0.605, p = 0.008) following 12 weeks of treatment. Conclusions: taken together, our findings indicate that individuals with AN present altered fronto-amygdalar response during cognitive reappraisal and that this response may serve as a predictor of response to treatment and be linked to clinical severity

Si ocurrió un evento adverso piense en decir “lo siento”

Fundamento. La información al paciente víctima de un evento adverso (EA) presenta ciertas particularidades en función del marco legal del país en el que se produzca, especialmente en lo referido al ofrecimiento de una disculpa. En el presente trabajo se pretende establecer los límites y las condiciones que debemos considerar a la hora de trasladar una disculpa al paciente que ha sufrido un EA. Método. Conferencia de consenso entre 26 profesionales de distintas comunidades autónomas, instituciones y perfiles profesionales con experiencia acreditada en la gestión de sistemas de Seguridad del Paciente y Derecho Penal de diferentes ámbitos laborales (sanidad, aseguradoras, inspección, académico). Resultados. El paciente, tras un EA además de ser informado, debiera recibir una disculpa expresada en términos neutros (manifestación empática y de pesar por lo sucedido), sin que el informante se identifique a sí mismo como responsable del daño, culpabilice a terceros, ni ofrezca una compensación en nombre de la compañía aseguradora. El profesional que se siente más directamente involucrado en el incidente es normalmente el menos indicado para informar y disculparse. El informante debe ajustarse al tipo y gravedad del EA. La normativa y condiciones del seguro de responsabilidad aconsejan no ofrecer información concreta sobre la magnitud de la compensación. Conclusiones. La disculpa debe medirse en función del marco normativo que rige en cada país. En nuestro caso procede una respuesta de empatía hacia el paciente, manifestando pesar por lo sucedido (decir lo siento) que puede facilitar la relación con el paciente, reducir su desconfianza y el número de litigios. Background. Disclosing information to a patient who is a victim of an adverse event (AE) presents some particularities depending on the legal framework in the country where the AE occurred. The aim of this study is to identify the limits and conditions when apologizing to a patient who has suffered an AE. Methods. A consensus conference involving 26 professionals from different autonomous communities, institutions, and profiles (health, insurance, inspection, academic) with accredited experience in patient safety management systems and criminal law. Results. Open disclosure should include an apology expressed in neutral terms (showing empathy and regret for what has happened) without the informant being identified as responsible for the damage, blaming third parties, or offering compensation on behalf of the insurance company. The professional who feels most directly involved in the incident is usually the least likely to report it and apologise. The informant profile must conform to the type and severity of the AE. The rules and conditions of liability insurance advise against providing specific information on the amount of compensation. Conclusions. The apology should be offered in terms of the regulatory framework in force in each country. In Spain, an appropriate response of empathy for the patient is warranted, expressing regret for what happened (apologising), which can facilitate the relationship with the patient, mitigate their mistrust, and reduce the number of disputes

Microbial communities of the olive mill wastewater sludge stored in evaporation ponds: The resource for sustainable bioremediation

Olive Mill Wastewater (OMW) is a polluting residue from the olive oil industry. It is usually stored in open-air unprotected evaporation ponds where their sediments accumulate. This study compares the characteristics of OMW sludges stored for long-time in evaporation ponds and assesses their impact on the underlying soil layer. Physicochemical parameters, toxicity bioassays, and full characterization of the microbial community were analyzed. The extension of the polluting effects was assessed by analysis of toxicity, microbial biomass carbon, and respiration. Geostatistics was used to predict their spatial distribution. Organic matter and polyphenol content besides toxicity levels determine variations between OMW sludges and have a high impact on the microbiota they contain. The microbial community was abundant, diverse, and functionally active. However, the biodegradability of the sludges was hindered by the toxicity levels. Toxicity and biomass carbon were higher on the surface of the ponds than in the soil layer revealing a reduced leach flow and depletion of contaminants. The natural microbiota might be biostimulated by means of applying sustainable and feasible biological treatments in order to favor the OMW sludges bioremediation. These results open up the possibility of solving the environmental concern caused by its storage in similar scenarios, which are common in olive oil-producing countries

Influence of elevated-CRP level-related polymorphisms in non-rheumatic Caucasians on the risk of subclinical atherosclerosis and cardiovascular disease in rheumatoid arthritis

Association between elevated C-reactive protein (CRP) serum levels and subclinical atherosclerosis and cardiovascular (CV) events was described in rheumatoid arthritis (RA). CRP, HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 exert an influence on elevated CRP serum levels in non-rheumatic Caucasians. Consequently, we evaluated the potential role of these genes in the development of CV events and subclinical atherosclerosis in RA patients. Three tag CRP polymorphisms and HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 were genotyped in 2,313 Spanish patients by TaqMan. Subclinical atherosclerosis was determined in 1,298 of them by carotid ultrasonography (by assessment of carotid intima-media thickness-cIMT-and presence/absence of carotid plaques). CRP serum levels at diagnosis and at the time of carotid ultrasonography were measured in 1,662 and 1,193 patients, respectively, by immunoturbidimetry. Interestingly, a relationship between CRP and CRP serum levels at diagnosis and at the time of the carotid ultrasonography was disclosed. However, no statistically significant differences were found when CRP, HNF1A, LEPR, GCKR, NLRP3, IL1F10, PPP1R3B, ASCL1, HNF4A and SALL1 were evaluated according to the presence/absence of CV events, carotid plaques and cIMT after adjustment. Our results do not confirm an association between these genes and CV disease in RA