Estudio para medir el nivel de adopcion de Internet de las Universidades Chilenas en base al modelo eMica.

67 p.El propósito del siguiente estudio es conocer el grado de adopción institucional de Internet en las universidades chilenas. Para ello se utilizó el modelo extendido de adopción del comercio en Internet (eMICA), que consta de tres etapas: promoción, provisión y procesamiento el cual ya había sido utilizado en la industria del turismo en el año 2000 en Australia, Nueva Zelanda y Chile. Este modelo provee indicadores que permiten determinar el nivel de desarrollo alcanzado por las páginas Web de cada universidad, debido a que incorpora tres niveles de procesos comerciales: promoción, provisión y procesamiento. Para tales efectos, se evaluaron las 60 universidades existentes en el país. Además fueron clasificadas de acuerdo a diversos criterios, que permitieron realizar un estudio comparativo dentro de la industria dándose un mayor énfasis a la Universidad de Talca. Los resultados a grandes rasgos revelaron que el 75% de las universidades chilenas se encuentran en la etapa 3 de procesamiento del modelo eMICA lo que refleja que han alcanzado un alto nivel funcionalidad en sus páginas Web. Es destacable que ninguna de ellas se encuentra en los niveles más bajos. Palabras claves: promoción, provisión, procesamiento, adopción

Mecanismo evolutivo del origen de genes superpuestos convergentes

87 p.La secuenciación de diversos genomas muestra que los genes se encuentran sometidos a una selección y pueden evolucionar a través del tiempo. Un ejemplo de ello es la superposición de genes, característica usualmente asociada a los virus, y que se presenta cuando una misma secuencia de ADN codifica para dos proteínas en marcos de lectura distintos. La finalidad de esta Memoria es estudiar genes superpuestos de orientación convergente mediante el análisis de su origen, de modo de explicar por qué determinados genes se encuentran separados en ciertos genomas y en otros están superpuestos. Con este conocimiento se podrá entender el modo en que surge una región codificante a partir de una que no lo es y generar un modelo de cómo nuevas secuencias de aminoácidos emergen de regiones no codificantes para determinadas duplas de genes superpuestos. Las principales herramientas de trabajo fueron los árboles filogenéticos, creados con el programa MrBayes 3.1.1, los scripts en lenguaje de programación Perl y BioPerl, la Base de Datos “Clusters of Orthologous Groups” (COGs) y ClustalW2 para alineamientos múltiples. Los resultados indican que cuando uno de los genes sufre una mutación, inserción, deleción o alteración del marco de lectura que altera el codón de término del gen, se produce una extensión de la secuencia hasta el siguiente codón de término, originando la superposición con el gen adyacente y la expresión de una nueva secuencia genómica. Este cambio en el gen puede permanecer por una selección positiva en el genoma, otorgando cierta estabilidad al cambio, si representa una característica positiva para el genoma. Es incluso posible que la secuencia extendida pueda adquirir nuevas propiedades con el paso del tiempo./ ABSTRACT: The sequencing of several genomes shows that genes are subject of selection and can evolve over time. An example of this are overlapping genes, a feature usually associated with viruses, which occurs when the same sequence of DNA encodes two proteins in different open reading frames. The purpose of this report is to study convergent overlapping genes through its origin analysis, which could explain why certain genes are separated in some genomes and are overlapped in others. With this knowledge it will be possible to understand how a coding region arise from a non-coding one, and generate a model of how new aminoacid sequences emerge from non-coding regions for certain pairs of overlapping genes. The main tools used were phylogenetic trees, created with MrBayes 3.1.1 program, scripts in Perl programming language and BioPerl, the “Cluster of Orthologous Groups” (COGs) database, and ClustalW2 for multiple sequences alignment. The results show that when a gene suffers a mutation, insertion, deletion or frame shift that modify the gene stop codon, it produces an extension of the sequence to the next stop codon, causing the overlap with the adjacent gene and the expression of a new genomic sequence. This change in the gene may remain by a positive selection in the genome, giving some stability to the modification, if its represent a positive feature for the genome. It is even possible that the extended sequence could acquire new properties with the passing of time

Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial

Background: Technological support using e-health mobile applications (m-health) is a promising strategy to improve the adherence to healthy lifestyles in breast cancer survivors (excess in energy intake or low physical activity are determinants of the risk of recurrence, second cancers and cancer mortality). Moreover, cancer rehabilitation programs supervised by health professionals are needed due to the inherent characteristics of these breast cancer patients. Our main objective is to compare the clinical efficacy of a m-health lifestyle intervention system alone versus an integral strategy to improve Quality of Life in breast cancer survivors. Methods: This therapeutic superiority study will use a two-arm, assessor blinded parallel RCT design. Women will be eligible if: they are diagnosed of stage I, II or III-A breast cancer; are between 25 and 75 years old; have a Body Mass Index > 25 kg/m2; they have basic ability to use mobile apps; they had completed adjuvant therapy except for hormone therapy; and they have some functional shoulder limitations. Participants will be randomized to one of the following groups: integral group will use a mobile application (BENECA APP) and will receive a face-to-face rehabilitation (8-weeks); m-health group will use the BENECA app for 2-months and will received usual care information. Study endpoints will be assessed after 8 weeks and 6 months. The primary outcome will be Quality of Life measured by The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core and breast module. The secondary outcomes: body composition; upper-body functionality (handgrip, Disability of the Arm, Shoulder and Hand questionnaire, goniometry); cognitive function (Wechsler Adult Intelligence Scale, Trail Making Test); anxiety and depression (Hospital Anxiety and Depression Scale); physical fitness (Short version of the Minnesota Leisure Time Physical Activity Questionnaire, Self-Efficacy Scale for Physical Activity); accelerometry and lymphedema. Discussion: This study has been designed to seek to address the new needs for support and treatment of breast cancer survivors, reflecting the emerging need to merge new low cost treatment options with much-needed involvement of health professionals in this type of patients. Trial registration: ClinicalTrials.gov Identifier: NCT02817724 (date of registration: 22/06/2016).The study was funded by the Spanish Ministry of Economy and Competitiveness (Plan Estatal de I + D + I 2013-2016), Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI14/01627), Fondos Estructurales de la Unión Europea (FEDER) and by the Spanish Ministry of Education (FPU14/01069). This is part of a Ph.D. Thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of the University of Granada, Spain

El lado humano de la sostenibilidad : reflexiones desde lo privado y lo público

1 documento en PDF de 31 páginasPara hablar de sostenibilidad, es preciso aclarar que el término va más allá del concepto medio ambiente; aborda todas las actividades del ser humano, desde su ámbito privado y cotidiano, hasta las acciones públicas que comparte con diferentes actores sociales; de tal manera que unos y otros son responsables del equilibrio de la vida. Los autores de este libro, por ejemplo, investigan y analizan el concepto de cuidado y sus dinámicas al interior de la familia, la percepción masculina del cuidado doméstico; cómo se perciben e interiorizan los términos educación y ciudadanía en la vida cotidiana; qué significa la discapacidad y cómo funcionan las familias con integrantes discapacitados. Y así como se tocan temas que, por su carácter doméstico y corriente, afectan la balanza de la sostenibilidad, de igual manera se revisan otros con igual o mayor peso en la sostenibilidad humana, como la responsabilidad social empresarial y la gobernanza del sistema de salud. El Cuidado En El Ámbito Privado || El Cuidado En El Ámbito Públic

Una mirada a las diferentes perspectivas de los negocios internacionales: estrategias, principios y casos de internacionalización

Este libro consolida resultados de investigación que permiten mirar los negocios internacionales a partir de diferentes perspectivas, proporcionando un aporte sistémico para la academia y el mercado. A partir de discusiones del punto de vista de relaciones internacionales, comercio exterior, logística, estrategias de internacionalización y negociación, esta obra discute aspectos actuales aplicables y relacionados a la actuación de las empresas colombianas en el mercado internacional, sus oportunidades y potencialidades competitivas. A lo largo de sus siete capítulos e introducción, el libro “Una mirada a las diferentes perspectivas de los Negocios Internacionales: Estrategias, principios y casos de internacionalización” presenta diferentes metodologías, herramientas, fundamentos y casos de referencia que pueden apoyar profesionales en el estudio y en la práctica de los negocios internacionales

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701