DESARROLLO DE DIAGNÓSTICO ORGANIZACIONAL APLICANDO LAS LEYES GENERALES DE LOS SISTEMAS Y LÓGICA DIFUSA PARA EVALUAR SISTEMAS SUAVES (DEVELOPMENT OF ORGANIZATIONAL DIAGNOSTIC APPLYING THE GENERAL LAWS OF THE SYSTEMS AND FUZZY LOGIC TO EVALUATE SOFT SYSTEMS)

Resumen Los mercados globales se han vuelto más competitivos en comparación a tiempos anteriores. Las empresas deben centrarse en evaluar constantemente el desempeño de su sistema con el fin de asegurar el cumplimiento de sus objetivos organizacionales. Para problemas complejos, Peter Checkland desarrolló en 1981 la metodología de sistemas suaves. Esta metodología será utilizada para analizar estos sistemas considerados como no estructurados o sistemas suaves. En esta investigación se propone el uso de las leyes generales de los sistemas y lógica difusa como herramientas para el desarrollo de un diagnóstico. Con las leyes generales de los sistemas se establecerán los criterios a evaluar. Y, la lógica difusa servirá para generar una medición cuantitativa del sistema suave, ya que estos no tienen una estructura ordenada y se tiende a evaluarlos de manera subjetiva. El objetivo es poder evaluar información no estructurada o borrosa y poder generar una respuesta matemática a la situación actual del sistema. Palabras Clave: Leyes generales de los sistemas, Lógica difusa, Mediciones cualitativas, Sistemas suaves, Software Matlab®. Abstract Global markets have become more competitive compared to earlier times. Companies must focus on constantly evaluating the performance of their system in order to ensure the fulfillment of their organizational objectives. For complex problems, Peter Checkland developed the soft systems methodology in 1981. This methodology will be used to analyze these systems considered as unstructured or soft systems. This research proposes the use of the general laws of systems and fuzzy logic as tools for the development of a diagnosis. The criteria to be evaluated will be established with the general laws of the systems. And, fuzzy logic will serve to generate a quantitative measurement of the smooth system, since these do not have an ordered structure and they tend to be evaluated subjectively. The objective is to be able to evaluate unstructured or blurred information and to be able to generate a mathematical answer to the current situation of the system. Keywords: Fuzzy logic, General system laws, Matlab® Software, Qualitative measurements, Soft systems

Diversity of HLA Class I and Class II blocks and conserved extended haplotypes in Lacandon Mayans.

Here we studied HLA blocks and haplotypes in a group of 218 Lacandon Maya Native American using a high-resolution next generation sequencing (NGS) method. We assessed the genetic diversity of HLA class I and class II in this population, and determined the most probable ancestry of Lacandon Maya HLA class I and class II haplotypes. Importantly, this Native American group showed a high degree of both HLA homozygosity and linkage disequilibrium across the HLA region and also lower class II HLA allelic diversity than most previously reported populations (including other Native American groups). Distinctive alleles present in the Lacandon population include HLA-A*24:14 and HLA-B*40:08. Furthermore, in Lacandons we observed a high frequency of haplotypes containing the allele HLA-DRB1*04:11, a relatively frequent allele in comparison with other neighboring indigenous groups. The specific demographic history of the Lacandon population including inbreeding, as well as pathogen selection, may have elevated the frequencies of a small number of HLA class II alleles and DNA blocks. To assess the possible role of different selective pressures in determining Native American HLA diversity, we evaluated the relationship between genetic diversity at HLA-A, HLA-B and HLA-DRB1 and pathogen richness for a global dataset and for Native American populations alone. In keeping with previous studies of such relationships we included distance from Africa as a covariate. After correction for multiple comparisons we did not find any significant relationship between pathogen diversity and HLA genetic diversity (as measured by polymorphism information content) in either our global dataset or the Native American subset of the dataset. We found the expected negative relationship between genetic diversity and distance from Africa in the global dataset, but no relationship between HLA genetic diversity and distance from Africa when Native American populations were considered alone

Comportamiento de variables clínico-epidemiológicas en pacientes diagnosticados con ataque transitorio de isquemia cerebral

Introduction: cerebrovascular disease is one of the main causes of long-term disability, with a high incidence of transient brain ischemic attacks.Objective: to determine the behavior of clinical-epidemiological variables in patients admitted with the diagnosis of transient brain ischemic attacks at Roberto Rodriguez Fernandez General Provincial Teaching Hospital from Moron municipality, Ciego de Avila province.Method: an observational, descriptive, cross-sectional study was conducted during the period from September 2019 to January 2020. The target group consisted of 39 patients, working with all of them. Descriptive statistics was used, by distribution of data according to absolute and relative percentage frequency.Results: there was a predominance of patients aged 60 years and over (82,1 %) and male sex (66,7 %); high blood pressure (74,3 %) was the main risk factor for the development of a transient brain ischemia attack; 46,2 % of the patients attended the hospital 24 hours after the onset of symptoms. Of the patients, 46,2 % attended the hospital within 24 hours of the onset of symptoms.Conclusions: patients older than 60 years, as well as male patients, hypertensive and/or smokers were prone to the development of transient brain ischemic attack. Attendance at health services after 24 hours was common.Introducción: la enfermedad cerebrovascular constituye una de las principales causas de discapacidad a largo plazo, con alta incidencia de los ataques transitorios de isquemia cerebral.Objetivo: determinar el comportamiento de variables clínico-epidemiológicas en pacientes ingresados con diagnóstico de ataques transitorios de isquemia cerebral en el Hospital General Provincial Docente “Roberto Rodríguez Fernández” del municipio Morón, Ciego de Ávila.Método: se realizó un estudio observacional, descriptivo, de corte transversal, durante el periodo de septiembre de 2019 a enero de 2020. El universo estuvo conformado por 39 pacientes, trabajándose con la totalidad. Se utilizó estadística descriptiva, mediante distribución de los datos según frecuencia absoluta y relativa porcentual.Resultados: existió predominio del grupo de edad de 60 años y más (82,1 %) y del sexo masculino (66,7 %).  La hipertensión arterial (74,3 %) constituyó el principal factor de riesgo para el desarrollo de un ataque transitorio de isquemia cerebral. El 46,2 % de los pacientes asistieron al hospital pasadas 24 horas de haber iniciado los síntomas.Conclusiones: los pacientes mayores de 60 años, así como los pacientes de sexo masculino, hipertensos y/o fumadores fueron propensos al desarrollo de ataque transitorio de isquemia. Fue común la asistencia a los servicios de salud pasadas las 24 horas

Incidencia de la estrategia de resolución de problemas y su efecto en el desarrollo de competencias en el area de matematicas de los estudiantes de tercer ciclo de las escuelas del sector publico del distrito 01 del Departamento de Ahuachapan

Las matemáticas juegan un papel importante en la vida de los seres humanos, pues a través de ellas, las personas pueden desarrollar en gran medida su capacidad intelectual, convirtiéndose así, en herramientas fundamentales para el desarrollo social y económico de la sociedad. Es por ello que, bajo esa perspectiva, se considera relevante dedicar un tiempo y un esfuerzo personal a la investigación, específicamente este trabajo se orienta en ese sentido, tomando en cuenta, el estudiantado del nivel de tercer Ciclo, ya que es el nivel que da paso, como en el caso del noveno grado que es la antesala al nivel educativo de educación media

Nivel de información sobre fitoterapia en pacientes hipertensos de un consultorio médico. Área sur, Morón

Introduction: Arterial hypertension is the main factor related to mortality in the contemporary world. Medicinal plants are the source of many of the drugs in current use; they have proven their efficacy in multiple diseases, thus constituting an alternative for the treatment of various pathologies.Objective: to determine the level of information on phytotherapy in hypertensive patients belonging to the Family 20 Medical Clinic in the municipality of Morón, Ciego de Avila province.Methods: an observational, descriptive, cross-sectional, descriptive study was conducted from September 2019 to January 2020. The universe consisted of 173 hypertensive patients, working with all of them. Descriptive statistics and absolute and relative percentage frequencies were used to summarize the information.Results: 57.2% of the cases were female and 45.1% belonged to the age group over 65 years. The intermediate technical education level was observed in 26.6 % of the sample. According to the classification according to the type of hypertension, 53.8% presented systolic arterial hypertension. 62.4 % of the cases reported not using phytotherapy as an alternative medicine for the treatment of arterial hypertension and 59.0 % were uninformed.Conclusions: the study showed a high level of misinformation among patients about the use of phytotherapy as an alternative medicine for the treatment of arterial hypertension.Introducción: la hipertensión arterial es el principal factor relacionado con la mortalidad en el mundo contemporáneo. Las plantas medicinales son la fuente de muchos de los medicamentos de uso actual, estas han probado su eficacia en múltiples enfermedades, por lo que constituye una alternativa para el tratamiento de diversas patologías.Objetivo: determinar el nivel de información sobre fitoterapia en pacientes hipertensos pertenecientes al Consultorio Médico de la Familia 20 del municipio de Morón, provincia Ciego de Ávila.Métodos: se realizó un estudio observacional, descriptivo, de corte transversal, en el periodo comprendido de septiembre 2019 a enero del 2020. El universo estuvo conformado por 173 pacientes hipertensos, trabajando con la totalidad. Se utilizó estadística descriptiva y como medida de resumen de la información las frecuencias absolutas y relativas porcentuales.Resultados: el 57,2 % de los casos representó al sexo femenino y el 45,1 % perteneció al grupo de edades mayores de 65 años. El nivel educacional técnico medio terminado se observó en el 26,6 % de la muestra. Según la clasificación de acuerdo al tipo de hipertensión el 53,8% presentó hipertensión arterial sistólica. El 62,4 % de los casos refiere no utilizar la fitoterapia como medicina alternativa para el tratamiento de la hipertensión arterial y el 59,0 % se encontraban desinformados.Conclusiones: en el estudio realizado se observó un alto nivel de desinformación en los pacientes sobre el uso de la fitoterapia como medicina alternativa al tratamiento de la hipertensión arterial

The Different Microbial Etiology of Prosthetic Joint Infections According to Route of Acquisition and Time After Prosthesis Implantation, Including the Role of Multidrug-Resistant Organisms

The aim of our study was to characterize the etiology of prosthetic joint infections (PJIs)-including multidrug-resistant organisms (MDRO)-by category of infection. A multicenter study of 2544 patients with PJIs was performed. We analyzed the causative microorganisms according to the Tsukayama's scheme (early postoperative, late chronic, and acute hematogenous infections (EPI, LCI, AHI) and "positive intraoperative cultures" (PIC)). Non-hematogenous PJIs were also evaluated according to time since surgery: 12 months. AHIs were mostly caused by Staphylococcus aureus (39.2%) and streptococci (30.2%). EPIs were characterized by a preponderance of virulent microorganisms (S. aureus, Gram-negative bacilli (GNB), enterococci), MDROs (24%) and polymicrobial infections (27.4%). Conversely, coagulase-negative staphylococci (CoNS) and Cutibacterium species were predominant in LCIs (54.5% and 6.1%, respectively) and PICs (57.1% and 15.1%). The percentage of MDROs isolated in EPIs was more than three times the percentage isolated in LCIs (7.8%) and more than twice the proportion found in AHI (10.9%). There was a significant decreasing linear trend over the four time intervals post-surgery for virulent microorganisms, MDROs, and polymicrobial infections, and a rising trend for CoNS, streptococci and Cutibacterium spp. The observed differences have important implications for the empirical antimicrobial treatment of PJIs.Acknowledgments: This work was supported by the Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness (grant number PI15/1026) (Co-funded by European Regional Development Fund/European Social Fund "Investing in your future"). REIPI (Spanish Network for Research in Infectious Disease) is supported by the Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness, and by the European Development Regional Fund “A way to achieve Europe”

Multicentre, randomised, single-blind, parallel group trial to compare the effectiveness of a Holter for Parkinson's symptoms against other clinical monitoring methods: study protocol

Introduction In recent years, multiple studies have aimed to develop and validate portable technological devices capable of monitoring the motor complications of Parkinson's disease patients (Parkinson's Holter). The effectiveness of these monitoring devices for improving clinical control is not known. Methods and analysis This is a single-blind, cluster-randomised controlled clinical trial. Neurologists from Spanish health centres will be randomly assigned to one of three study arms (1:1:1): (a) therapeutic adjustment using information from a Parkinson?s Holter that will be worn by their patients for 7 days, (b) therapeutic adjustment using information from a diary of motor fluctuations that will be completed by their patients for 7 days and (c) therapeutic adjustment using clinical information collected during consultation. It is expected that 162 consecutive patients will be included over a period of 6 months. The primary outcome is the efficiency of the Parkinson?s Holter compared with traditional clinical practice in terms of Off time reduction with respect to the baseline (recorded through a diary of motor fluctuations, which will be completed by all patients). As secondary outcomes, changes in variables related to other motor complications (dyskinesia and freezing of gait), quality of life, autonomy in activities of daily living, adherence to the monitoring system and number of doctor?patient contacts will be analysed. The noninferiority of the Parkinson's Holter against the diary of motor fluctuations in terms of Off time reduction will be studied as the exploratory objective. Ethics and dissemination approval for this study has been obtained from the Hospital Universitari de Bellvitge Ethics Committee. The results of this study will inform the practical utility of the objective information provided by a Parkinson's Holter and, therefore, the convenience of adopting this technology in clinical practice and in future clinical trials. We expect public dissemination of the results in 2022.Funding This work is supported by AbbVie S.L.U, the Instituto de Salud Carlos III [DTS17/00195] and the European Fund for Regional Development, 'A way to make Europe'

Genome-wide meta-analysis for Alzheimer's disease cerebrospinal fluid biomarkers

Amyloid-beta 42 (A beta 42) and phosphorylated tau (pTau) levels in cerebrospinal fluid (CSF) reflect core features of the pathogenesis of Alzheimer's disease (AD) more directly than clinical diagnosis. Initiated by the European Alzheimer & Dementia Biobank (EADB), the largest collaborative effort on genetics underlying CSF biomarkers was established, including 31 cohorts with a total of 13,116 individuals (discovery n = 8074; replication n = 5042 individuals). Besides the APOE locus, novel associations with two other well-established AD risk loci were observed; CR1 was shown a locus for A beta 42 and BIN1 for pTau. GMNC and C16orf95 were further identified as loci for pTau, of which the latter is novel. Clustering methods exploring the influence of all known AD risk loci on the CSF protein levels, revealed 4 biological categories suggesting multiple A beta 42 and pTau related biological pathways involved in the etiology of AD. In functional follow-up analyses, GMNC and C16orf95 both associated with lateral ventricular volume, implying an overlap in genetic etiology for tau levels and brain ventricular volume.Peer reviewe