Presentación del dossier: La transformación social por medio del derecho

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Comparative study of 4 exploratory human-centred design tools when deployed in participatory health service settings

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonThe shift from traditional models of public service design to public-driven ones has been slow in the health service and particularly in the General Practice Consultation in the UK. This hesitation about fully adapting these design methods has been found to be motivated by a lack of evidence regarding the successful implementations of public involvement activities and the use of its tools, partial coverage of these tools, and failures to report on the use of alternative tools, among other reasons. This research therefore aimed to propose Human-Centred Design (HCD) as an underlying philosophy and a pragmatic set of methodologies to better understand the challenges related to the application of customer involvement activities and the use typical methods when deployed in the investigation of issues and opportunities for the design of healthcare settings. This research consisted of three stages. An exploration stage, in which it was identified and confirmed several research gaps as well as a specific case for study with a degree of complexity and known for supporting customer involvement approaches. These activities involved a literature review about customer involvement processes and a qualitative interview study (with 30 participants) in which it was identified that, a suitable case for study to perform a large ethnographic investigation using representative Human-Centred Design tools could be ‘Communication and relationship between GPs and patients’. A development stage, in which it was investigated the design of public involvement activities as well as the identification and selection process of some ideal HCD tools (Focus Groups, Future Workshops / Rich Pictures. Love & Break-up Letters, and Crowdsourcing) to work with the selected case. For these activities, a total of 72 participants were recruited (n=18 per activity). Lastly, an evaluation and proposal phase, analysed these tools through a comparative study to identify several of their strengths and weakness in order to identify the best tool or combination of tools. The outcome from this comparison suggested that among the tools used for this research there was not a most optimal option or combination of options and that the success of an involvement activity relies in the careful and thorough preparation of such processes. This research concludes, that the most optimal form of helping health researchers to undertake public involvement research and to better understand the process of identifying and selecting ideal engagement tools, could be by providing a best practice informative guide containing a simplified and comprehensive version of the most commonly found steps embedded in this kind of design practices

Caracterización de la Universidad Tecnológia de Bolívar basado en la perspectiva financiera y del cliente de el modelo Balanced Scorecard

Para el diseño de esta propuesta de implementación de un modelo de Balanced Scorecard es necesario describir la situación actual de la institución y el proceso de planeación como un método de reconocimiento de la realidad institucional y su desarrollo mediante el análisis de la realidad circundante y la delimitación de sus fortalezas y debilidades. Gracias a la ejecución de trabajos de diagnostico ejecutados interna y externamente por los distintos grupos de referencia institucional: el sector empresarial, la sociedad en general (padres de familia), estudiantes, profesores, egresados, empleados y planta administrativa se ha podido reconocer y determinar las prioridades que conllevan a definir iniciativas estratégicas que hagan realidad los objetivos estratégicos del modelo.Incluye bibliografí

Facial Geometry Identification through Fuzzy Patterns with RGBD Sensor

Automatic human facial recognition is an important and complicated task; it is necessary to design algorithms capable of recognizing the constant patterns in the face and to use computing resources efficiently. In this paper we present a novel algorithm to recognize the human face in real time; the systems input is the depth and color data from the Microsoft KinectTM device. The algorithm recognizes patterns/shapes on the point cloud topography. The template of the face is based in facial geometry; the forensic theory classifies the human face with respect to constant patterns: cephalometric points, lines, and areas of the face. The topography, relative position, and symmetry are directly related to the craniometric points. The similarity between a point cloud cluster and a pattern description is measured by a fuzzy pattern theory algorithm. The face identification is composed by two phases: the first phase calculates the face pattern hypothesis of the facial points, configures each point shape, the related location in the areas, and lines of the face. Then, in the second phase, the algorithm performs a search on these face point configurations

Will Organoids Fill the Gap towards Functional Precision Medicine?

Precision medicine approaches for solid tumors are mainly based on genomics. Its employment in clinical trials has led to somewhat underwhelming results, except for single responses. Moreover, several factors can influence the response, such as gene and protein expression, the coexistence of different genomic alterations or post-transcriptional/translational modifications, the impact of tumor microenvironment, etc., therefore making it insufficient to employ a genomics-only approach to predict response. Recently, the implementation of patient-derived organoids has shed light on the possibility to use them to predict patient response to drug treatment. This could offer for the first time the possibility to move precision medicine to a functional environment

Rendimiento financiero en pequeñas y medianas empresas (pymes): un análisis bibliométrico de la producción científica

SMEs play a leading role in the global economy, which is why their study is increasing attracting the interest of the scientific and academic community. This article explores the development of research in financial issues, which is one of the relevant aspects for the growth and competitiveness of this type of organizations. A scientific mapping of the research on financial performance and SMEs is carried out by tracking the scientific production registered in the Scopus and WoS databases. The most relevant regions, authors, institutions and journals are determined using bibliometric tools and techniques; the most representative documents of the area are also identified and classified using the metaphorical scheme of the tree. The results allowed to establish the seminal and structural works, as well as the sub-areas that emerge on the subject; the latter determine, in turn, the sub-areas or currents in which the research is framed. The most relevant country on this topic is Indonesia, followed by Australia and South Africa; the publication with the greatest impact is the UK Journal of Cleaner Production, and the most relevant author is Jain, Priyanka, from Delhi Technological University. Finally, an agenda for future research is proposed, including financial returns related to corporate social responsibility, business innovation and environmental sustainability.Las pymes desempeñan un papel protagónico en la economía global, por eso su estudio despierta cada vez más el interés de la comunidad científica y académica. Este artículo explora el desarrollado de la investigación sobre el tema financiero, uno de los aspectos relevantes para el crecimiento y la competitividad de este tipo de organizaciones. Se efectúa un mapeo científico de la investigación acerca del desempeño financiero y pymes, a través de un rastreo de la producción científica registrada en las bases de datos Scopus y WoS. Se determinan las regiones, los autores, las instituciones y revistas más relevantes utilizando herramientas y técnicas bibliométricas; también se identifican los documentos más representativos del área y se clasifican empleando el esquema metafórico del árbol. Los resultados permitieron establecer los trabajos seminales y estructurales, al igual que las subáreas que emergen sobre el tema; estas últimas determinan, a su vez,   las subáreas o corrientes en las que se enmarca la investigación. El país más relevante en este tópico es Indonesia, seguido de Australia y Sudáfrica; la publicación de mayor impacto es el Journal of Cleaner Production del Reino Unido, y el autor más relevante es Jain, Priyanka, de Delhi Technological University. Finalmente, se plantea una agenda para futuras investigaciones, entre ellas, los rendimientos financieros relacionados con la responsabilidad social corporativa, la innovación empresarial y el sostenimiento del medio ambiente

Coagulation Parameters: An Efficient Measure for Predicting the Prognosis and Clinical Management of Patients with COVID-19

Background. COVID-19 is an ongoing global pandemic. Since the detection of the first cases of coronavirus disease 2019 (COVID-19) in Wuhan, China, the current pandemic has affected more than 25.3 million people worldwide. The aim of this study was to evaluate the relationship between coagulation abnormalities and prognosis in a cohort of patients with COVID-19. Methods. We performed a retrospective cohort study of 3581 patients admitted to Hospital La Paz (Madrid, Spain) due to respiratory infection by severe acute respiratory syndrome coronavirus from the beginning of the current pandemic to 15 July 2020. Results. Of the 3581 study patients, 48.94% were men, and 19.80% were healthcare workers. The median age was 62 years. Compared with the survivors, the non-survivors had lower prothrombin activity (82.5 (Interquartile range-IQR, 67-95) vs. 95.25 (IQR, 87-104) for non-survivors and survivors, respectively; p < 0.001), higher fibrinogen levels (748.5-IQR, 557-960) vs. 572.75 (IQR, 417-758; p < 0.001), and notably higher D-dimer levels (2329-IQR, 1086.12-5670.40) vs. 635.5 (IQR, 325.5-1194.8); p < 0.001). Conclusions. The evaluation of coagulation parameters could be an efficient measure for predicting the prognosis and improving the clinical management of patients with COVID-19

Oculocardiac Reflex During Intravitreal Injection

Oculocardiac reflex (OCR) has been described to occur with mechanical manipulation of the eye, eyelids or orbit. There are no reports in the literature of OCR during intravitreal injection (IVI). This may be due to the fact that heart rate is not monitored during the procedure. We aimed to evaluate OCR during IVI. A total of 532 patients were enrolled in the study in Asociacion para Evitar la Ceguera en Mexico. Mexico City, Mexico. IVI was performed on one eye in every patient with diabetic retinopathy (DR), age related macular degeneration (AMD) or choroidal neovascularization (CNV) secondary to pathological myopia. Heart rate was monitored with a pulse oximeter before, during and after injection. OCR was defined as a 20% decrease or more of basal heart rate. The population enrolled included 270 females and 262 males with mean age of 63.8 years. A decrease in heart rate of 20% or more occurred in 18 patients during IVI (3.3%; 95% confidence interval 1.85% and 4.92%). OCR was asymptomatic in these patients. OCR occurred in 3.3% of our patients during IVI. Hence, OCR must be considered when performing IVI

Effects of dietary inclusion of dry distillers grains with solubles on performance, carcass characteristics, and nitrogen metabolism in meat sheep: a meta-analysis

We conducted a meta-analysis in this scientific study to determine the effects of feeding meat sheep dry distillers grains with solubles (DDGS). Thirty-three peer-reviewed articles that met our inclusion requirements and were published between 1997 and 2021 were examined. To calculate the variation in performance, fermentation, carcass features, and nitrogen efficiency between the DDGS and control (no DDGS) treatments, we used 940 sheep weighing an average of 29.1 ± 1.5 kg. We used a hierarchical mixed model to conduct a meta-regression, subset, and dose–response analysis, while taking into consideration categorical variables like breed (pure or cross-breed), and continuous factors, like CP, NDF, and DDGS inclusion rate. Our findings indicate that sheep fed DDGS had higher (p &lt; 0.05) final body weight (51.4 vs. 50.4 kg), neutral detergent fiber digestibility (55.9 vs. 53.8%), and total-tract ether extract digestibility (81.7 vs. 78.7%) than sheep on a control diet. No effects were observed on DMI, CP, and rumen fermentation, but dietary DDGS tended to increase (p = 0.07) HC weight (25.53 vs. 24.6 kg) and meat (redness) color (16.6 vs. 16.3) among treatment comparisons. Dietary DDGS was associated with higher N intake (29.9 vs. 26.8 g/d), fecal N (8.2 vs. 7.8 g/d), and digestibility (71.9 vs. 68.5%). Urinary nitrogen was significantly (p &lt; 0.05) affected linearly by increasing the intake of DDGS in the diet. Based on the dose–response analysis, dietary DDGS inclusion should not exceed 20% to avoid negative effects on performance, nitrogen metabolism, and meat color. Dietary protein from DDGS should not exceed 17% to prevent reduced TVFA concentrations. Breed strongly influenced (p &lt; 0.05) RMD in performance, and inconsistent responses were observed between crossbreed and purebred sheep comparisons. Despite these inconsistencies, no publication bias was observed, but a high variance (Ω2) among comparisons-between-studies was detected. This meta-analysis showed evidence in support of the hypothesis that feeding meat sheep DDGS at a rate of 20% can improve their performance, digestibility, carcass weight, and meat color

Enfermedad de Hirschsprung, a propósito de un caso

Introduction: Hirschsprung's disease (HD) is within theclinical context one of Pediatric diseases that lowerIncidencehas, representing barely 2.7% of all of them, according todata from the American College of Pediatrics (ACP). However, its pathophysiologyand clinical behavior governed by the age of the patient are&nbsp;the main variablesthat complicate the diagnosis and give errors of up to 35%(ACP). The mortality of patients can amount up to 65% whenthe EH is complicated with a picture of Necrotizingenterocolitis, in a patient who has notbeen theeliminationof meconium within the first 12 hours of life must suspecteh, always takinginto account the patient's age and recallingthat preterm the same delay can be considered normal, while in the case oflarger aged patients the incidence of thedisease is lower, however the diagnostic probability should not be disregarded. Sepsis in abdominal origin andnecrotising enterocolitis are two of the major complicationsof which the physician should be prevented, even when, asreported in the present case, even patients who are opposedto the main factors of risk described in literature, such asage, can develop a HD box and a latent risk of complicationlikethe rest of patients that if shared these risk factors. Objective: To describe a case of Hirschsprung's disease. Material and methods: a descriptive, retrospective studyabout Hirschsprung's disease clinical case presenta-tion. Results: Describes a case of Hirschsprung's disease inpediatric patient with complications and resolution satisfactory quirurgica. Conclusions: The proper implementation of the clinicalmethod allows an accurate diagnosis and timely treatmentof Hirschsprung's disease.Introducción: La Enfermedad deHirschsprung (EH) es dentro del contexto clínico-quirúrgico una de las patologías pediátricas que menor incidencia posee, representando a penas el 2,7% de todas ellas según datos del Colegio Americano de Pediatría (ACP). Sin embargo, su fisiopatología y su comportamiento clínico regido por la edad del paciente son las principales variables que complican el diagnóstico y dan errores de hasta un 35% (ACP). La mortalidad de los pacientes puede ascender hasta un 65% cuando la EHse complica con un cuadro de enterocolitis necrotizante, en un paciente que no se ha conseguido la eliminación de meconio dentro de las 12 primeras horas de vida deberá sospecharse de EH, siempre tomando en cuenta la edad del pacientey recordando que en pretérminos el retraso del mismopuede considerarse normal, mientras que en el caso de pacientes más grandes de edadla incidencia de la patología es menor, sin embargo la probabilidad diagnóstica no debe de ser menospreciada. La sepsis de origen abdominal y enterocolitis necrotizante son dos de las grandes complicaciones de las cuales el médico debe estar prevenido, más aún, cuando, como se relata en el presente caso clínico, incluso pacientes que se contraponen a los principales factores de riesgo descritos por la literatura, como la edad, pueden desarrollar un cuadro de EH y tener un riesgo latente de complicación al igual que el resto de pacientes que si comparten dichos factores de riesgos. Objetivo: Describir un caso clínico de Enfermedad de Hirschsprung. Material y métodos: Se realizó un estudio descriptivo, retrospectivo, presentación de caso clínico sobre Enfermedad de Hirschsprung. Resultados: Se describe un caso de Enfermedad de Hirschsprung en paciente pediátrico con complicaciones y resolución quirpurgica satisfactoria. Conclusiones: La adecuada aplicación del método clínico permite un diagnóstico preciso y tratamiento oportuno de la Enfermedad de Hirschsprung