Ambiente virtual de aprendizaje como herramienta didáctica para el aprendizaje de la robótica educativa en estudiantes del grado décimo del I.C.S desde un enfoque holístico transformador

Con base en la problemática que presentaban los estudiantes del grado décimo del Instituto Colombo Sueco I.C.S localidad 1 Bogotá, relacionada con el área de tecnología e informática, específicamente con la temática de robótica educativa, se diseñó e implementó un Ambiente Virtual de Aprendizaje con el fin de mejorar significativamente el proceso de enseñanza aprendizaje en la construcción de robots teleoperadores enfocados en los insectoides. El A.V.A estuvo orientado por el Modelo Pedagógico Holístico Transformador del Dr. Giovanni Iafrancesco Villegas a través de la plataforma Moodle, cuyo contenido es un software libre que permite la creación de módulos estructurados con actividades específicas esenciales en el diseño de ambientes virtuales. La investigación benefició a los estudiantes de los niveles básica y media y educadores-mediadores que enseñaron la temática de robótica educativa ya que ampliaron sus conocimientos frente al tema, tuvieron a su disposición el (AVA) diseñado específicamente para tal fin, que además cumplió el propósito de ser un instrumento para gestionar procesos de enseñanza aprendizaj

Ambiente virtual de aprendizaje como herramienta didáctica para el aprendizaje de la robótica educativa en estudiantes del grado décimo del I.C.S desde un enfoque holístico transformador

Con base en la problemática que presentaban los estudiantes del grado décimo del Instituto Colombo Sueco I.C.S localidad 1 Bogotá, relacionada con el área de tecnología e informática, específicamente con la temática de robótica educativa, se diseñó e implementó un Ambiente Virtual de Aprendizaje con el fin de mejorar significativamente el proceso de enseñanza aprendizaje en la construcción de robots teleoperadores enfocados en los insectoides. El A.V.A estuvo orientado por el Modelo Pedagógico Holístico Transformador del Dr. Giovanni Iafrancesco Villegas a través de la plataforma Moodle, cuyo contenido es un software libre que permite la creación de módulos estructurados con actividades específicas esenciales en el diseño de ambientes virtuales. La investigación benefició a los estudiantes de los niveles básica y media y educadores-mediadores que enseñaron la temática de robótica educativa ya que ampliaron sus conocimientos frente al tema, tuvieron a su disposición el (AVA) diseñado específicamente para tal fin, que además cumplió el propósito de ser un instrumento para gestionar procesos de enseñanza aprendizaj

Plan Estratégico de responsabilidad social para la empresa Muebles tu Hogar

El proyecto posee información para instruir mediante estrategias que agrupan a todos los actores ( Stakeholders y demás participantes activos en el ámbito empresarial, con el fin de poder aportar soluciones en la aplicación e interpretación de la norma para tomar decisiones dentro de la organización acertadamente . Con este trabajo final de grado se espera que sea un instrumento de apoyo en los conocimientos logrados en el diplomado de profundización en Gerencia Estratégica y Responsabilidad Social Empresarial.The project has information to instruct through strategies that bring together all the actors (Stakeholders and other active participants in the business field, in order to be able to provide solutions in the application and interpretation of the standard to make decisions within the organization correctly. With This final degree project is expected to be an instrument to support the knowledge achieved in the deepening diploma in Strategic Management and Corporate Social Responsibility. As administrators we are going to apply our knowledge to the company MUEBLES TU HOGAR, noting that there are weaknesses in the administrative structure of the organization, for this reason we are going to incorporate strategic management and corporate social responsibility to implement a strategic plan with the correct use of the ISO 26000 standard. It is important to highlight that the information obtained was given through the instrument applied as was the interview, which was carried out or within the company, with the collaboration of all the staff, from the data obtained, the logical framework was created, which gave results, which will help decision-making through strategies, which will give relevance to the future, as a socially responsible company that is linked to its environment, in community

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Evaluación de las propiedades termodinámicas de sorción de la uchuva (physalis peruviana l.)

El equilibrio de sorción de agua a diferentes temperaturas (25, 35, 50 y 60°C) enun rango de humedad relativa, de 0.10 a 0.85, se determinó para la uchuva usandoun método gravimétrico estático. El calor isostérico y la energía libre de Gibbsse calcularon desde el equilibrio de sorción. Los modelos de GAB, BET, SMITH,el modificado de Halsey, el modificado Chung-Pfost, el modificado de Oswin y elmodificado de Henderson fueron probados para ajustar los datos experimentales. Elmodelo GAB fue el más adecuado para describir las curvas de sorción. Los valoresde contenido de humedad de la monocapa para la sorción a diferentes temperaturasfueron calculados usando el modelo BET. El calor isostérico decrece con el incrementoen el contenido de humedad, mientras que la energía libre de Gibbs incrementa

Vaginal cuff brachytherapy in endometrial cancer &ndash; a technically easy treatment?

Sebasti&agrave; Sabater,1 Ignacio Andres,1 Veronica Lopez-Honrubia,1 Roberto Berenguer,1 Marimar Sevillano,1 Esther Jimenez-Jimenez,2 Angeles Rovirosa,3 Meritxell Arenas,4 1Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete, Albacete, 2Department of Radiation Oncology, Hospital Son Espases, Palma de Mallorca, 3Department of Radiation Oncology, Hospital Clinic, Barcelona, 4Department of Radiation Oncology, Hospital Universitari Sant Joan, Reus, Spain Abstract: Endometrial cancer (EC) is one of the most common gynecological cancers among women in the developed countries. Vaginal cuff is the main location of relapses after a curative surgical procedure and postoperative radiation therapy have proven to diminish it. Nevertheless, these results have not translated into better survival results. The preeminent place of vaginal cuff brachytherapy (VCB) in the postoperative treatment of high- to intermediate-risk EC was given by the PORTEC-2 trial, which demonstrated a similar reduction in relapses with VCB than with external beam radiotherapy (EBRT), but VCB induced less late toxicity. As a result of this trial, the use of VCB has increased in clinical practice at the expense of EBRT. A majority of the clinical reviews of VCB usually address the risk categories and patient selection but pay little attention to technical aspects of the VCB procedure. Our review aimed to address both aspects. First of all, we described the risk groups, which guide patient selection for VCB in clinical practice. Then, we depicted several technical aspects that might influence dose deposition and toxicity. Bladder distension and rectal distension as well as applicator position or patient position are some of those variables that we reviewed. Keywords: endometrial cancer, vaginal cuff brachytherapy, rectum, bladder, techniqu

Effect of nitric oxide on mitochondrial respiratory activity of human articular chondrocytes

Objective: To investigate the effect of nitric oxide (NO) on mitochondrial activity and its relation with the apoptosis of human articular chondrocytes. Materials and methods: Mitochondrial function was evaluated by analysing respiratory chain enzyme complexes, citrate synthase (CS) activities, and mitochondrial membrane potential (Δψm). The activities of the mitochondrial respiratory chain (MRC) complexes (complex I: NADH CoQ(1) reductase, complex II: succinate dehydrogenase, complex III: ubiquinol cytochrome c reductase, complex IV: cytochrome c oxidase) and CS were measured in human articular chondrocytes isolated from normal cartilage. The Δψm was measured by 5,5',6,6'-tetracholoro-1,1',3,3'-tetraethylbenzimidazole carbocyanide iodide (JC-1) using flow cytometry. Apoptosis was analysed by flow cytometry. The mRNA expression of caspases was analysed by ribonuclease protection analysis and the detection of protein synthesis by western blotting. Sodium nitroprusside (SNP) was used as an NO compound donor. Results: SNP at concentrations higher than 0.5 mmol/l for 24 hours induced cellular changes characteristic of apoptosis. SNP elicited mRNA expression of caspase-3 and caspase-7 and down regulated bcl-2 synthesis in a dose and time dependent manner. Furthermore, 0.5 mM SNP induced depolarisation of the mitochondrial membrane at 5, 12, and 24 hours. Analysis of the MRC showed that at 5 hours, 0.5 mM SNP reduced the activity of complex IV by 33%. The individual inhibition of mitochondrial complex IV with azide modified the Δψm and induced apoptosis. Conclusions: This study suggests that the effect of NO on chondrocyte survival is mediated by its effect on complex IV of the MRC