Diseño de un modelo para el desarrollo de aplicaciones graduales Multi-Disciplinarias en Dispositivos Móviles

Normalmente cuando se desarrolla algún software ya sea para la gestión de artículos, control de usuarios,ingresos, egresos, entre otros, se recurre a la Ingeniería de Software, la cual contiene procedimientos, técnicas y herramientas para la elaboración de un producto que resuelva una problemática o necesidad del cliente. El enfoque de dichos procedimientos y técnicas está relacionado más con la satisfacción del cliente y la infraestructura tecnológica. Un software común puede resolverse considerando sólo esos dos factores,logrando productos con impacto y resultados óptimos. Por otro lado, cuando se habla del software educativo, se siguen utilizando dichos parámetros, la satisfacción del cliente e infraestructura; no obstante, la elaboración de programas de este tipo implica procesos adicionales, incluso antes siquiera de decidir el medio donde será ejecutado el producto. Es razón por la cuál se propone un modelo que establezca los procesos para cumplir objetivos tanto pedagógicos como tecnológicos. En la parte educativa, se analizaron diversos modelos pedagógicos, particularmente el construccionismo, que se apoya de estrategias de aprendizaje como el basado en problemas, el cambio conceptual y la simulación. Un modelo en particular aprovecha parte de estas características para ayudar a promover la compresión de un tema en específico; a pesar de orquestar contenido didáctico de forma satisfactoria, no puede ser utilizado directamente para el desarrollo de software. En cuanto a la parte tecnológica, se analizaron las apps educativas más populares en las tiendas virtuales (Google Play, Microsoft Store y App Store), lo cual permitió identificar puntos fuertes y débiles del software educativo. De este modo se decidió en emplear Sistemas Tutoriales Inteligentes que tienen cierta reputación en guiar al usuario a un mejor aprendizaje por medio de módulos potenciados con Inteligencia Artificial. A pesar de contar con muchas bondades, dicha arquitectura, por su nivel de complejidad, difícilmente se encontraban aplicaciones en los dispositivos móviles, ya que el limitado poder de procesamiento, la pantalla y almacenamiento planteaban desafíos de diseño y algoritmos. Con ambas partes identificadas, se recurrió a la Ingeniería de Procesos, que permitió a través de múltiples iteraciones llegar a un modelo que guíe los procedimientos educativos y tecnológicos a un fin común. Dicho modelo fue separado en cuatro fases que a grandes rasgos son: identificar necesidades educativas; utilizar las mejores técnicas y estrategias de aprendizaje; encontrar una arquitectura de software en la cual se piensa desarrollar; unificar los resultados del procedimiento educativo en las primeras fases de la construcci on del software educativo; y por último, efectuar la programación necesaria. En conclusión, el modelo abarca cuestiones educativas y tecnológicas que permitan cumplir un mismo objetivo, al considerar por separado ambas áreas para ser unificadas y potenciarlas. Esto también permitió agregar los enfoques graduales y multi-disciplinarios, debido a que en el transcurso de la investigación fueron las desventajas más comunes que poseen las aplicaciones existentes en el mercado, logrando satisfacer múltiples necesidades. Es probable que con este modelo se reduzca la brecha entre la educación y la tecnología, ya que se concentra en las expectativas instruccionales y no en la novedad tecnológica

Implementación de un Sistema Web-Móvil para agilizar el proceso de Cadena de Custodia

En el presente trabajo se llevó a cabo la Implementación de un Sistema Web-Móvil para agilizar el proceso de Cadena de Custodia considerando como base la información que se encuentra en la página oficial del Consejo Nacional de Seguridad Pública, así como de los diferentes formatos que utiliza actualmente el cuerpo de policía en México. Se realizó una investigación documental sobre el software existente en el mercado, dónde se encontró una diversidad que no contempla la parte administrativa, la mayoría de las ocasiones son programas para computa- dora específicos, encargados de analizar huellas digitales, detección de rostro, herramientas para extracción de evidencia en dispositivos móviles, entre otros; lo qúe da apertura para la elaboración de este Sistema que se encarga de apoyar en documentar de manera digital las acciones del primer respondiente. A lo largo de este trabajo se describen las diversas herramientas que se utilizaron para el desarrollo del sistema, así, cómo diferentes problemas presentados a lo largo del desarrollo que fueron resueltas a través de desarrollo de software

Prevalence and risk factors of Strongyloides stercoralis in haemodialysis in Cochabamba, Bolivia: a cross-sectional study.

BACKGROUND Strongyloidiasis is an infectious disease that can be fatal in immunocompromised patients. Patients with end-stage renal failure who are on dialysis have a considerably weakened immune system, and organ transplantation is a major risk factor for severe strongyloidiasis. Knowledge of the local epidemiology in tropical and subtropical areas is an essential prerequisite for designing an appropriate strategy to prevent this potentially lethal complication. In this study, we aimed to estimate the prevalence and associated risk factors of S. stercoralis infection in patients on dialysis in Cochabamba, Bolivia. METHODS A cross-sectional study was carried out among patients undergoing haemodialysis in Cochabamba (elevation 2,500 m, temperate climate), collecting information on socio-demographic, lifestyle, and clinical variables, and using one coproparasitological technique (the modified Baermann technique) and one serological (ELISA) test for S.stercoralis diagnosis. RESULTS In total, 149 patients participated in the study (mean age = 51.4 years, 48.3% male). End-stage renal disease was predominantly (59%) of hypertensive and/or diabetic origin. The positive serological prevalence was 18.8% (95% CI: 13.3%-25.9%). Based on the sensitivity and specificity of the ELISA test, the estimate of the actual prevalence was 15.1% (95% CI: 9.4%-20.7%). Stool samples of 105 patients (70.5%) showed a coproparasitological prevalence of 1.9% (95% CI: 0.52%-6.68%). No potential risk factors were significantly associated with S. stercoralis infection. CONCLUSIONS We found a high seroprevalence of S. stercoralis in Bolivian patients undergoing haemodialysis in Cochabamba. We recommend presumptive antiparasitic treatment at regular intervals to avoid the potentially fatal complications of severe strongyloidiasis

Contested Futures: Envisioning “Personalized,” “Stratified,” and “Precision” Medicine

In recent years, discourses around “personalized,” “stratified,” and “precision” medicine have proliferated. These concepts broadly refer to the translational potential carried by new data-intensive biomedical research modes. Each describes expectations about the future of medicine and healthcare that data-intensive innovation promises to bring forth. The definitions and uses of the concepts are, however, plural, contested and characterized by diverse ideas about the kinds of futures that are desired and desirable. In this paper, we unpack key disputes around the “personalized,” “stratified,” and “precision” terms, and map the epistemic, political and economic contexts that structure them as well as the different roles attributed to patients and citizens in competing future imaginaries. We show the ethical and value baggage embedded within the promises that are manufactured through terminological choices and argue that the context and future-oriented nature of these choices helps to understanding how data-intensive biomedical innovations are made socially meaningful

A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

BACKGROUND: To identify the best possible outcomes in liver transplantation from donation after circulatory death donors (DCD) and to propose outcome values, which serve as reference for individual liver recipients or patient groups. METHODS: Based on 2219 controlled DCD liver transplantations, collected from 17 centres in North America and Europe, we identified 1012 low-risk, primary, adult liver transplantations with a laboratory MELD of ≤20points, receiving a DCD liver with a total donor warm ischemia time of ≤30minutes and asystolic donor warm ischemia time of ≤15minutes. Clinically relevant outcomes were selected and complications were reported according to the Clavien-Dindo-Grading and the Comprehensive Complication Index (CCI). Corresponding benchmark cut-offs were based on median values of each centre, where the 75(th)-percentile was considered. RESULTS: Benchmark cases represented between 19.7% and 75% of DCD transplantations in participating centers. The one-year retransplant and mortality rate was 5.23% and 9.01%, respectively. Within the first year of follow-up, 51.1% of recipients developed at least one major complication (≥Clavien-Dindo-Grade-III). Benchmark cut-offs were ≤3days and ≤16days for ICU and hospital stay, ≤66% for severe recipient complications (≥Grade-III), ≤16.8% for ischemic cholangiopathy, and ≤38.9CCI points at one-year posttransplant. Comparisons with higher risk groups showed more complications and impaired graft survival, outside the benchmark cut-offs. Organ perfusion techniques reduced the complications to values below benchmark cut-offs, despite higher graft risk. CONCLUSIONS: Despite excellent 1-year survival, morbidity in benchmark cases remains high with more than half of recipients developing severe complications during 1-year follow-up. Benchmark cut-offs targeting morbidity parameters offer a valid tool to assess the protective value of new preservation technologies in higher risk groups, and provide a valid comparator cohort for future clinical trials. LAY SUMMARY: The best possible outcomes after liver transplantation of grafts donated after circulatory death (DCD) were defined using the concept of benchmarking. These were based on 2219 liver transplantations following controlled DCD donation in 17 centres worldwide. The following benchmark cut-offs for the most relevant outcome parameters were developed: ICU and hospital stay: ≤3 and ≤16 days; primary non function: ≤2.5%; renal replacement therapy: ≤9.6%; ischemic cholangiopathy: ≤16.8% and anastomotic strictures ≤28.4%. One-year graft loss and mortality were defined as ≤14.4% and 9.6%, respectively. Donor and recipient combinations with higher risk had significantly worse outcomes. The use of novel organ perfusion technology achieved similar, good results in this high-risk group with prolonged donor warm ischemia time, when compared to the benchmark cohort

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

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An embedding technique to determine ττ backgrounds in proton-proton collision data

An embedding technique is presented to estimate standard model tau tau backgrounds from data with minimal simulation input. In the data, the muons are removed from reconstructed mu mu events and replaced with simulated tau leptons with the same kinematic properties. In this way, a set of hybrid events is obtained that does not rely on simulation except for the decay of the tau leptons. The challenges in describing the underlying event or the production of associated jets in the simulation are avoided. The technique described in this paper was developed for CMS. Its validation and the inherent uncertainties are also discussed. The demonstration of the performance of the technique is based on a sample of proton-proton collisions collected by CMS in 2017 at root s = 13 TeV corresponding to an integrated luminosity of 41.5 fb(-1).Peer reviewe