Diseño e implementación de un sistema de segmentación de los juegos de casinos de acuerdo con su nivel de actividad

El sector al cual apunta nuestro proyecto es el sector de la industria del Juego, específicamente en el sistema de las máquinas tragamonedas, las cuales bajo la perspectiva de un modelo de minería de datos permita a los administradores obtener conclusiones a fin de aplicarlas en su modelo de negocios. Específicamente tratamos el negocio de la empresa Interecuador S.A. dedicada al negocio de explotación de máquinas tragamonedas en calle, en locales y en salas de juego y casinos. El negocio posee diversos productos que pueden ser catalogados bajo dos grandes categorías: Mesas y máquinas. Dentro de mesas abarca todos los juegos de azar basados en cartas que tienen la intervención humana, este tipo de productos es exclusivo de casinos. Dentro de máquinas existen múltiples variedades de marcas, modelos y juegos los cuales se utilizan tanto en el negocio de calle, locales, casinos y salas de juego. Dadas las diversas características de los mismos es necesaria la implementación de un método que nos permita explorar los datos y encontrar la mejor combinación de características de determinada máquina de manera que su implementación en determinado local basado en la estadística me garantice la mejor producción de la misma

Professional education in tourism between connections and learning networks

Artículo completoLos planteamientos vertidos en este artículo tienen como propósito argumentar las nuevas dinámicas de aprendizaje y escenarios para la formación en turismo, así como sus implicaciones en el ámbito profesional, que son favorecidos por la cultura digital. El estudio parte de la etnografía virtual e identifica redes de turismo en Latino-iberoamérica que propician mediaciones en una práctica educativa abierta y expansiva en la cultura digital. Los resultados se presentan con base en categorías de análisis y se concluye sobre las posibles transformaciones que han de gestarse en el ámbito educativo como un proceso de interactividad e interacción combinado entre los actores involucrados desde la academia y en la actividad turística.ITESO, Universidad Jesuita de Guadalajar

CONSTRUCCIÓN EMERGENTE DEL CONCEPTO: CUIDADO PROFESIONAL DE ENFERMERÍA

El objetivo del presente trabajo fue la construcción del concepto cuidado profesional de enfermería. Las aportaciones se encaminan a la dimensión profesional del campo de la ciencia de la enfermería. Es un estudio cualitativo con enfoque Hermenéutico, en 20 enfermeras, mediante entrevistas semiestructuradas a profundidad. El análisis fue de contenido. El cuidado profesional lo conceptualizan como el cuidado de la vida de las personas que solicitan sus servicios. Con ello, el hacer de la enfermera viene a ser un acto profesional y no un acto de buenas intensiones, con la obligación de asumir conductas de cuidado, que conlleva principios y normas establecidas por la disciplina. Las enfermeras entienden que se requiere de conocimientos constantes. La conceptualización del cuidado profesional que se apoya en la práctica, ofrece un acercamiento a la construcción de la Ciencia de la Enfermería

Propuesta didáctica para la detección y mejora de las actitudes posturales incorrectas de la columna

En este artículo realizamos una propuesta didáctica que tiene los siguientes objetivos: conocer la morfología normal de la columna, detectar anomalías en dicha morfología, así como discernir cuáles son debidas a hábitos posturales incorrectos. Finalmente proponemos un plan de ejercicios que los corrija

Contexto histórico del cuidado profesional de Enfermería en México

La Enfermería mexicana fue construyendo, como proceso histórico, un cuerpo de saberes en un acto dialéctico permanente: Ser, saber y hacer en enfermería se amalgaman para otorgar un cuidado profesional de enfermería. Objetivo: reflexionar y argumentar sobre el desarrollo del cuidado profesional, hasta transformarse en el acto monopólico o cuerpo de saberes de la profesión de enfermería en México. Se empleó el método analítico-sintético, apoyado en la hermenéutica. Se revisaron textos que abordan el cuidado desde enfoques diversos: humanismo, medicina, sociología y enfermería. Resultados: El conocimiento y la asunción del cuidado como objeto epistémico de la profesión de enfermería en México es reciente. Ha sido un ejercicio lento, difícil de entender, de transmitir y, sobre todo, de aplicar en cada una de las áreas laborales. Conclusiones: Existe un trabajo colegiado permanente para posicionar el otorgamiento de un cuidado profesional, solidario y ciudadano

Incongruence between transcriptional and vascular pathophysiological cell states

Research in R.B.’s laboratory was supported by the European Research Council Starting Grant AngioGenesHD (638028) and Consolidator Grant AngioUnrestUHD (101001814), the CNIC Intramural Grant Program Severo Ochoa (11-2016-IGP-SEV-2015-0505), the Ministerio de Ciencia e Innovación (MCIN) (SAF2013-44329-P, RYC-2013- 13209, and SAF2017-89299-P) and ‘La Caixa’ Banking Foundation (HR19-00120). J.V.’s laboratory was supported by MCIN (PGC2018- 097019-B-I00 and PID2021-122348NB-I00) and La Caixa (HR17-00247 and HR22-00253). K.G.’s laboratory was supported by Knut and Alice Wallenberg Foundation (2020.0057) and Vetenskapsrådet (2021-04896). The CNIC is supported by Instituto de Salud Carlos III, MCIN, and the Pro CNIC Foundation, and is a Severo Ochoa Center of Excellence (grant CEX2020-001041-S funded by MCIN/ AEI/10.13039/501100011033). Microscopy experiments were performed at the Microscopy and Dynamic Imaging Unit, CNIC, ICTS-ReDib, co-funded by MCIN/AEI/10.13039/501100011033 and FEDER ‘Una manera de hacer Europa’ (ICTS-2018-04-CNIC-16). M.F.-C. was supported by PhD fellowships from La Caixa (CX_E-2015-01) and Boehringer Ingelheim travel grants. S.M. was supported by the Austrian Science Fund (J4358). A.R. was supported by the Youth Employment Initiative (PEJD-2019-PRE/BMD-16990). L.G.-O. was supported by the Spanish Ministry of Economy and Competitiveness (PRE2018-085283). We thank S. Bartlett (CNIC) for English editing, as well as the members of the Transgenesis, Microscopy, Genomics, Citometry and Bioinformatic units at CNIC. We also thank F. Radtke (Swiss Institute for Experimental Cancer Research), R. H. Adams (Max Planck Institute for Molecular Biomedicine), F. Alt (Boston Children’s Hospital, Harvard Medical School), T. Honjo (Kyoto University Institute for Advanced Studies), I. Flores (CNIC), J. Lewis (Cancer Research UK London Research Institute), S. Habu (Tokai University School of Medicine), T. Gridley (Maine Health Institute for Research) and C. Brakebusch (Biotech Research and Innovation Centre) for sharing the Dll4floxed, Notch1floxed, Notch2floxed, Cdh5(PAC)-creERT2, Myc floxed, Rbpj floxed, p21−/−, Jag1floxed, Dll1floxed, Jag2floxed and Rac1floxed mice.S

Recommendations for screening, monitoring, prevention, and prophylaxis of infections in adult and pediatric patients receiving CAR T-cell therapy : a position paper

Chimeric antigen receptor (CAR) T-cell therapy is one of the most promising emerging treatments for B-cell malignancies. Recently, two CAR T-cell products (axicabtagene ciloleucel and tisagenlecleucel) have been approved for patients with aggressive B-cell lymphoma and acute lymphoblastic leukemia; many other CAR-T constructs are in research for both hematological and non-hematological diseases. Most of the patients receiving CAR-T therapy will develop fever at some point after infusion, mainly due to cytokine release syndrome (CRS). The onset of CRS is often indistinguishable from an infection, which makes management of these patients challenging. In addition to the lymphodepleting chemotherapy and CAR T cells, the treatment of complications with corticosteroids and/or tocilizumab increases the risk of infection in these patients. Data regarding incidence, risk factors and prevention of infections in patients receiving CAR-T cell therapy are scarce. To assist in patient care, a multidisciplinary team from hospitals designated by the Spanish Ministry of Health to perform CAR-T therapy prepared these recommendations. We reviewed the literature on the incidence, risk factors, and management of infections in adult and pediatric patients receiving CAR-T cell treatment. Recommendations cover different areas: monitoring and treatment of hypogammaglobulinemia, prevention, prophylaxis, and management of bacterial, viral, and fungal infections as well as vaccination prior and after CAR-T cell therapy

Passive smoking in babies: The BIBE study (Brief Intervention in babies. Effectiveness)

Background: There is evidence that exposure to passive smoking in general, and in babies in particular, is an important cause of morbimortality. Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome, acute respiratory diseases, worsening of asthma, acute-chronic middle ear disease and slowing of lung growth. The objective of this article is to describe the BIBE study protocol. The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care, directed to mothers and fathers that smoke, in order to reduce the exposure of babies to passive smoking (ETS). Methods/Design: Cluster randomized field trial (control and intervention group), multicentric and open. Subject: Fathers and/or mothers who are smokers and their babies (under 18 months) that attend pediatric services in Primary Care in Catalonia. The measurements will be taken at three points in time, in each of the fathers and/or mothers who respond to a questionnaire regarding their baby's clinical background and characteristics of the baby's exposure, together with variables related to the parents' tobacco consumption. A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit (biological determination of nicotine). The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care. Discussion: Exposure to ETS is an avoidable factor related to infant morbimortality. Interventions to reduce exposure to ETS in babies are potentially beneficial for their health. The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits. Interventions in the form of advice, conducted by pediatric professionals, are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS

Does Consumption of Ultra-Processed Foods Matter for Liver Health? Prospective Analysis among Older Adults with Metabolic Syndrome

Non-alcoholic fatty liver disease (NAFLD) includes a spectrum of liver alterations that can result in severe disease and even death. Consumption of ultra-processed foods (UPF) has been associated with obesity and related comorbidities. However, the link between UPF and NAFLD has not been sufficiently assessed. We aimed to investigate the prospective association between UPF consumption and liver health biomarkers. Methods: We followed for 1 year 5867 older participants with overweight/obesity and metabolic syndrome (MetS) from the PREDIMED-Plus trial. A validated 143-item semi-quantitative food frequency questionnaire was used to evaluate consumption of UPF at baseline, 6, and 12 months. The degree of processing for foods and beverages (g/day) was established according to the NOVA classification system. The non-invasive fatty liver index (FLI) and hepatic steatosis index (HSI) were used to evaluate liver health at three points in time. The associations between changes in UPF consumption (percentage of total daily dietary intake (g)) and liver biomarkers were assessed using mixed-effects linear models with repeated measurements. Results: In this cohort, UPF consumption at baseline was 8.19% (SD 6.95%) of total daily dietary intake in grams. In multivariable models, each 10% daily increment in UPF consumption in 1 year was associated with significantly greater FLI (β 1.60 points, 95% CI 1.24;1.96 points) and HSI (0.43, 0.29; 0.57) scores (all p-values < 0.001). These associations persisted statistically significant after adjusting for potential dietary confounders and NAFLD risk factors. Conclusions: A higher UPF consumption was associated with higher levels of NAFLD-related biomarkers in older adults with overweight/obesity and MetS

Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019

Altres ajuts: Departament de Salut. Generalitat de Catalunya ("Pla estratègic de recerca i innovació en salut (PERIS) 2019-2021"); Ministerio de Asuntos Económicos y Transformación Digital; Red Española de Investigación en Patología Infecciosa (REIPI).Background: Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim: To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat). Methods: A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000patientdays. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000patientdays and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results: During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate:0.20episodes/1,000patientdays). Patients' median age was 64.1years; 36.6% (3,403/9,290) were female. In total, 73.7% (n=6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n=5,822) were related to central venous catheter (CVC), 24.1% (n=2,236) to peripheral venous catheters (PVC) and 13.3% (n=1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR:0.94;95%CI:0.93-0.96), especially in the ICU (IRR:0.88;95%CI:0.87-0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR:0.88;95%CI:0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC:1.08;95%CI:1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions: Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards