Imaging characteristics of the patient with Fanconi anemia: a case report

La anemia de Fanconi (AF) es una enfermedad autosómica recesiva que se caracteriza por la presencia de aplasia de la medula ósea y que generalmente se acompaña de diversas malformaciones con-génitas y la presencia de síndrome mielodisplásico o de leucemia mieloide aguda. Se presenta el caso de un paciente masculino de 6 años de edad, producto de un embarazo normal, que al examen físico presenta microcefalia y cuatro dedos en cada mano con aus-encia de los dedos pulgares; las imágenes diagnósticas muestran la presencia de aplasia radial y ausencia de los huesos carpianos radiales del miembro superior izquierdo. Se hace impresión diag-nóstica de anemia de Fanconi por exámenes de laboratorio. Al momento de sospechar el diagnóstico de AF, es importante tener en cuenta las distintas enfermedades que por sus característi-cas clínicas y las diferentes malformaciones congénitas que las acompañan se consideran diagnósticos diferenciales, y así poder realizar un adecuado manejo terapéutico. [Pérez AF, González JL. Características imaginológicas del paciente con anemia de Fanconi: informe de un caso. MedUNAB 2006; 9:179-182].Fanconi anemia (FA) is an autosomal recessive disease character-ized by the presence of bone marrow failure and that generally is accompanies by diverse congenital malformations and the presence of myelodysplastic syndrome or acute myeloid leukaemia. We report a case of male patient to 6 years old, product of a normal pregnancy, on physical examination his presents microcephaly and four fingers in each hand with absence of the thumbs; the radiological images show to the presence of radial aplasia and absence of the carpo-radial bones of the upper left limb. Diagnoses impression becomes of Fanconi anemia by laboratory tests. At the time of suspecting the diagnoses of FA, is important to consider the different diseases that by their clinical characteristics and the different congenital mal-formations they accompany them consider differential diagnoses, and thus to be able to make a suitable therapeutic handling. [Pérez AF, González JL. Imaginoligical characteristics of Fanconi anemia patient: case report. MedUNAB 2006; 9:179-182

Colombia Como un "Poder Medio Oceánico": Análisis de las Interacciones del País Dentro de la Región de la Cuenca del Caribe

In recent years, Colombia has grown as a protagonist in the realities of Latin America. The country is in a favorable geographical position because it is located in the northern corner of South America, which allows it to interact not only regionally with South America but also with Central America and the Caribbean. In addition, the recent peace agreement with an insurgent group and the power vacuum left by its demobilization have developed regional opportunities and threats not only at the national level, but also the impact of transnational criminal organizations at the regional level. Taking into account a constructivist approach to international security and following the concepts of “Regional Security Complex” (CSR) and “Medium Oceanic Power”, the present manuscript analyzes how the Colombian government has been interacting with other states in the Caribbean Watersheds Region to generate common security and defense conditions.En los últimos años, Colombia ha crecido como protagonista en las realidades de América Latina. El país se encuentra en una posición geográfica favorable al encontrarse en la esquina norte de América del Sur, lo que le permite interactuar no solo regionalmente con Sudamérica sino también con Centro América y el Caribe. Además, el reciente acuerdo de paz con un grupo insurgente y el vacío de poder que dejó su desmovilización han desarrollado oportunidades regionales y amenazas no solo a nivel nacional, sino también se debe considerar el impacto de organizaciones delictivas transnacionales a nivel regional. Teniendo en cuenta un enfoque constructivista de seguridad internacional y siguiendo los conceptos de “Complejo de Seguridad Regional” (CSR) y “Poder Medio Oceánico”, el presente manuscrito realiza un análisis acerca de cómo el gobierno colombiano ha venido interactuando con otros estados en la Región de la Cuenca del Caribe para generar condiciones de seguridad y defensa común

A P–Lingua Based Simulator for Spiking Neural P Systems

The research within the field of Spiking Neural P systems (SN P systems, for short) is focusing mainly in the study of the computational completeness (they are equivalent in power to Turing machines) and computational efficiency of this kind of systems. These devices have been shown capable of providing polynomial time solutions to computationally hard problems by making use of an exponential workspace constructed in a natural way. In order to experimentally explore this computational power, it is necessary to develop software that provides simulation tools (simulators) for the existing variety of SN P systems. Such simulators allow us to carry out computations of solutions to NP-complete problems on certain instances. Within this trend, P-Lingua provides a standard language for the definition of P systems. As part of the same project, pLinguaCore library provides particular implementations of parsers and simulators for the models specified in P-Lingua. In this paper, an extension of the P-Lingua language to define SN P systems is presented, along with an upgrade of pLinguaCore including a parser and a new simulator for the variants of these systems included in the language.Ministerio de Ciencia e Innovación TIN2009–13192Junta de Andalucía P08-TIC-0420

Simulacros hospitalarios en Colombia ¿Un requisito legal o una necesidad en la gestión del riesgo?

Currently in Colombia the educational institutions and business buildings work in an average of fortyeight (48) hours per week, the hospitals and other health centers instead are among the few institutions in the country that operate day and night without interruption, with physical facilities and a human group varied which makes them more vulnerable to the risk of emergencies and disasters of different origin and that with a threat of danger they harm the welfare of staff. For this reason, this review article begins with the establishment from the perspective of some authors of the concepts related to risk management, emergency plans and simulacrum, also investigates the current legal regulation in Colombia applicable to these practices known also as care emergency response and finally terminated if the hospital simulations in Colombia are just a legal requirement or a latent need of the risk management.Keywords: Risk management, hospital, simulations.En Colombia actualmente las instituciones educativas y edificios empresariales laboran en un promedio de cuarenta y ocho (48) horas semanales; los hospitales y demás establecimientos de salud por el contrario, son de los pocos establecimientos en el país que operan día y noche sin interrupción, con instalaciones físicas y un grupo humano variado que los hace más vulnerables al riesgo de emergencias o desastres de diferente origen, y que ante una amenaza de peligro atentan contra el bienestar del personal. Por esta razón, el presente artículo de revisión inicia con el establecimiento desde la perspectiva de algunos autores de los conceptos relacionados con gestión del riesgo, planes de emergencia hospitalario y los simulacros, asimismo indaga sobre la normatividad legal vigente en Colombia aplicable a estas prácticas conocidas también como atención de respuesta ante emergencias y, finalmente concluye si los simulacros hospitalarios en Colombia son solo un requisito legal o una necesidad latente en la gestión del riesgo.Palabras Clave: Gestión del riesgo, hospital, simulacros

DCBA: Simulating Population Dynamics P Systems with Proportional Object Distribution

Population Dynamics P systems refer to a formal framework for ecological modelling. The semantics of the model associates probabilities to rules, but at the same time, the model is based on P systems, so the rules are applied in a maximally parallel way. Since the success of the rst model using this framework [5], initially called multienvironment probabilistic P systems, several simulation algorithms have been de ned in order to better reproduce the behaviour of the ecosystems with the models. BBB and DNDP are previous attempts, which de ne blocks of rules having the same left-hand side, but do not de ne a deterministic behaviour when di erent rules are competing for the same resources. That is, di erent blocks of rules present in their lefthand side common objects, being applicable at the same time. In this paper, we introduce a new simulation algorithm, called DCBA, which performs a proportional distribution of resources.Junta de Andalucía P08-TIC04200Ministerio de Educación y Ciencia TIN2009-1319

Variación temporal de los índices de sensibilidad de un modelo de cultivo para jitomate en invernadero

Decision support systems (DSS) are tools that can be based on a crop model and are used to manage certain aspects in an agro-system such as: irrigation scheduling, climate control, fertilization, and yields. HORTSYST is a dynamic growth model, developed to be implemented in an expert system to manage irrigation and crop nutrition in intensive systems. It has 16 parameters, three state variables: dry matter production (DMP), photothermal index (PTI) and absorbed nitrogen (Nup), besides two output variables; Crop transpiration (ETc) and Leaf Area Index (LAI). The inputs of the model are: Global solar radiation (Rg), air temperature (Ta) and relative humidity (Hr). The simulations of HORTSYST model are based on estimation of a photothermal index. Which represents the development time of crop, which LAI is calculated. ETc is estimated with a mass and energy balance equation. DMP is determined with the radiation use efficiency (RUE) approach and Nup is calculated with dilution curve of nitrogen content in DMP. The objective of this work is to perform a global sensitivity analysis using the Sobol´s method, to know the importance of each parameter in the output variables at ten days after transplantation (DDT), during the vegetative stages (25 DDT), beginning of fruiting (40 DDT), harvest (80 DDT) and at the end (119 DDT) of the tomato crop cycle (Solanum lycopersicum L.), grown hydroponically in a greenhouse during spring-summer. It was found that the main and total effect indices, as a measure of the influence of the parameters, do not follow an established order as the crop cycle progresses. This temporal variation is a function of the stage of development and should be considered when conducting a sensitivity analysis.Los sistemas soporte de decisiones (SSD) son herramientas que pueden tener de base un modelo de cultivo y se utilizan para el manejo de ciertos aspectos en un agro-sistema como: programación de riego, control climático, fertilización y rendimientos. HORTSYST es un modelo dinámico de crecimiento, desarrollado para implementarse en un sistema experto para manejar el riego y nutrición de cultivos en sistemas intensivos. Cuenta con 16 parámetros, tres variables de estado: Producción de materia seca (DMP), índice fototérmico (PTI) y nitrógeno absorbido (Nup), además de dos variables de salidas; Transpiración del cultivo (ETc) e índice de Área foliar (LAI). Las variables de entrada son: La radiación solar global (Rg), temperatura del aire (Ta) y humedad relativa (Hr).  La parte central del modelo es la estimación de un índice fototérmico, que representa al tiempo de desarrollo del cultivo con el que se simula LAI. La ETc se estima con una ecuación de balance de masa y energía. DMP se simula con el enfoque de la eficiencia del uso de la radiación (RUE). Nup se determina con la curva de dilución del nitrógeno y DMP simulado previamente. El objetivo de este trabajo es realizar un análisis de sensibilidad global mediante el método de Sobol, para conocer la importancia de cada parámetro en las variables de salida, a los diez días después de trasplante (DDT), durante la etapa vegetativa (25 DDT), inicio de la fructificación (40 DDT), cosecha (80 DDT) y al final (119 DDT) del ciclo del cultivo de jitomate (Solanum lycopersicum L.), cultivado en hidropónia en invernadero durante primavera-verano (S-S). Se encontró que los índices de efectos principales y totales, como medida de influencia de los parámetros, no siguen un orden establecido con forme avanza el ciclo de cultivo. Esta variación temporal está en función de la etapa de desarrollo y debe considerarse al realizar un análisis de sensibilidad

Telegestión simulada para la enseñanza a estudiantes de medicina sobre la toma de decisiones en gestión en el primer nivel de atención de salud

Introduction: Medical students are poorly prepared in health services management due to the use of traditional teaching methods, developed in theoretical environments with poor active participation. Virtual simulated training is an innovative alternative in the learning process. Objective: This study aimed to determine the knowledge improvement in managerial decision-making amongst medical students at the Universidad Nacional Mayor de San Marcos in Peru, after a virtual simulated training. Methods: A before-after cross-sectional design was undertaken among final year medical students to measure their improvement in management knowledge. The simulation methodology was used as a component of the Medical Externship clinical course in which the administrative dimension of a clinical case such as hypoacusis was considered. Results: Of the 79 participants, 48 (60.8%) were female and the median age was 25 years. There was a median satisfaction level of 3.8 and the performance median score was 17. The median post-test rank scores were higher and statistically significant than pre-test rank scores (p = 0.004); post-test scores for males (p-value = 0.05) and females (p = 0.03) were also statistically higher than pre-test scores. Conclusion: The non-clinical simulation experience improves the knowledge on managerial decision making. It also opens opportunities to work on management issues in clinical courses, providing a comprehensive learning experience. On the other hand, it is an innovative experience where a clinical course adopts a management component.Introducción: Los estudiantes de medicina están poco preparados en gestión de servicios de salud debido al uso de métodos de enseñanza tradicionales, llevados a cabo en entornos teóricos y poco participativos. La formación virtual simulada es una alternativa innovadora en el proceso de aprendizaje. Objetivo: Determinar la mejora en conocimientos sobre la toma de decisiones gerenciales entre los estudiantes de medicina de la Universidad Nacional Mayor de San Marcos en Perú, tras un entrenamiento simulado virtual. Métodos: Estudio de diseño transversal de antes-después en estudiantes de último año de medicina. La metodología de simulación se utilizó como un componente del curso clínico de externado, en el que se consideró la dimensión administrativa de un caso clínico de hipoacusia. Resultados: De los 79 participantes, 48 (60,8%) eran mujeres y la edad media era de 25 años. La mediana del nivel de satisfacción fue de 3,8 y la mediana del rendimiento fue de 17. La mediana de las puntuaciones del post-test fue mayor y estadísticamente significativa en comparación a la del pre-test (p = 0,004); las puntuaciones post-test fueron más altas que las puntuaciones pre-test para los hombres (p = 0,05) y mujeres (p = 0,03). Conclusiones: La experiencia de simulación no clínica logra una mejora significativa en el conocimiento de los participantes. Además, abre oportunidades para trabajar los temas de gestión en los cursos clínicos, proporcionando una experiencia de aprendizaje integral. Por otro lado, es una experiencia innovadora en la que un curso clínico adopta un componente de gestión

Ocupando espaços, compartilhando saberes

O presente projeto de extensão trata da interação institucional entre IFC- São Francisco do Sul e a Escola Básica Municipal João Germano Machado, com o objetivo de promover a cooperação entre as instituições parceiras, mobilizando através de ação extensionista servidores, alunos e comunidade externa. Possibilitando o uso dos espaços educativos para a realização atividades de pesquisa, leitura, práticas esportivas, lúdicas e culturais. O trabalho segue a Metodologia Participativa, baseada na Pedagogia de Paulo Freire e outros autores que seguem a mesma linha. Os resultados ainda são parciais, pois o trabalho encontra-se em fase execução

OCUPANDO ESPAÇOS, COMPARTILHANDO SABERES

O presente projeto de extensão trata da interação institucional entre IFC IFC- São Francisco do Sul e a Escola Básica Municipal João Germano Machado, com o objetivo de promover a cooperação entre as instituições parceiras, mobilizando através de ação extensionista servidores, alunos e comunidade externa. Possibilitando o uso dos espaços educativos para a realização atividades de pesquisa, leitura, práticas esportivas, lúdicas e culturais. O trabalho segue a Metodologia Participativa, baseada na Pedagogia de Paulo Freire e outros autores que seguem a mesma linha. Os resultados ainda são parciais, pois o trabalho encontra-se em fase execução

Use and acceptance of long lasting insecticidal net screens for dengue prevention in Acapulco, Guerrero, Mexico

Background Dengue, recognized by the WHO as the most important mosquito-borne viral disease in the world, is a growing problem. Currently, the only effective way of preventing dengue is vector control. Standard methods have shown limited effect, and there have been calls to develop new integrated vector management approaches. One novel tool, protecting houses with long lasting insecticidal screens on doors and windows, is being trialled in a cluster randomised controlled trial by a joint UADY/WHO TDR/IDRC study in various districts of Acapulco, Mexico, with exceptionally high levels of crime and insecurity. This study investigated the community’s perspectives of long lasting insecticidal screens on doors and windows in homes and in schools, in order to ascertain their acceptability, to identify challenges to further implementation and opportunities for future improvements. Methods This was a sequential mixed-methods study. The quantitative arm contained a satisfaction survey administered to 288 houses that had received the intervention examining their perspectives of both the intervention and dengue prevention in general. The qualitative arm consisted of Focus Group Discussions (FGDs) with those who had accepted the intervention and key informant interviews with: schoolteachers to discuss the use of the screens in schools, program staff, and community members who had refused the intervention. Results Overall satisfaction and acceptance of the screens was very high, with only some operational and technical complaints relating to screen fragility and the installation process. However, the wider social context of urban violence and insecurity was a major barrier to screen acceptance. Lack of information dissemination and community collaboration were identified as project weaknesses. Conclusions The screens are widely accepted by the population, but the project implementation could be improved by reassuring the community of its legitimacy in the context of insecurity. More community engagement and better information sharing structures are needed. The screens could be a major new dengue prevention tool suitable for widespread use, if further research supports their entomological and epidemiological effectiveness and their acceptability in different social and environmental contexts. Further research is needed looking at the impact of insecurity of dengue prevention programmes