Estrategia de interacción para soporte a la toma de decisión en situaciones cotidianas

El objetivo de este trabajo de tesina es proponer y evaluar diferentes alternativas en los sistemas de soporte para la toma de decisiones. Para tal fin se presentará una variación en los sistemas que se han tomado como caso de estudio, lo cual se basa en el comportamiento detectado durante la interacción y los conceptos de racionalidad limitada y adaptación de aspiraciones. Tales conceptos identifican el comportamiento de los seres humanos en la toma de decisiones y proveen de mecanismos abstractos para enriquecer los sitios de estudio y permitirá a los usuarios cumplir de manera eficaz con sus objetivos en la Interacción.Facultad de Informátic

Sex differences in patterns of referral and resource utilization in the cardiology clinic: an outpatient analysis.

AIMS Women may have different management patterns than men in specialised care. Our aim was to assess potential sex differences in referral, management and outcomes of patients attending outpatient cardiac consultations. METHODS AND RESULTS Retrospective observational analysis of patients ≥18 years referred for the first time from primary care to a tertiary hospital cardiology clinic in 2017-2018, comparing reasons for referral, decisions and post-visit outcomes by sex.A total of 5,974 patients, 2,452 (41.0%) men aged 59.2 ± 18.6 years and 3,522 (59.0%) women aged 64.5 ± 17.9 years (P < 0.001) were referred for a first cardiology consultation. The age-related referral rates were higher in women. The most common reasons for consultation were palpitations in women (n = 676; 19.2%) and ECG abnormalities in men (n = 570; 23.2%). Delays to cardiology visits and additional tests were similar. During 24 months of follow-up, women had fewer cardiology hospitalisations (204; 5.8% vs. 229; 9.3%; P = 0.003) and lower mortality (65; 1.8% vs. 66; 2.7%; P = 0.028), but those aged <65 years had more emergency department visits (756; 48.5% vs. 560; 39.9%, P < 0.001) than men. CONCLUSION There are substantial sex differences in primary care cardiology referral patterns, including causes, rates, decisions and outcomes, which are only partially explained by age differences. Further research is needed to understand the reasons for these differences.This work was supported by the Sociedad Española de Cardiología y Fundación Española del Corazón (Grant SEC/FECINV-CLI 21/009). LV is funded by the Instituto de Salud Carlos III, Spain (CM20/00104 and JR22/00004). NR is funded by the Instituto de Salud Carlos III, Spain (CM22/00049). HB receives research funding from the Instituto de Salud Carlos III, Spain (PIE16/00021 & PI17/01799, PI21/01572), and Sociedad Española de Cardiología.S

Cocción óhmica de masas batidas libre de gluten

El objetivo de este trabajo fue evaluar experimentalmente la cocción de masa batida libre de gluten mediante un sistema de calentamiento óhmico, y realizar un modelo matemático simple del sistema, como así también realizar comparaciones con el horneado tradicional.Facultad de Ingenierí

Primary vs. Secondary Heart Failure Diagnosis: Differences in Clinical Outcomes, Healthcare Resource Utilization and Cost.

There is scarce information on patients with secondary heart failure diagnosis (sHF). We aimed to compare the characteristics, burden, and outcomes of sHF with those with primary HF diagnosis (pHF). Retrospective, observational study on patients ≥18 years with emergency department (ED) visits during 2018 with pHF and sHF in ED or hospital (ICD-10-CM) diagnostic codes. Baseline characteristics, 30-day and 1-year mortality, readmission and re-ED visit rates, and costs were compared between sHF and pHF. Out of the 797 patients discharged home from the ED, 45.5% had sHF, and these presented lower 1-year hospitalization, re-ED visit rates, and costs. In contrast, out of the 2,286 hospitalized patients, 55% had sHF and 45% pHF. Hospitalized sHF patients had significantly (p < 0.01) greater comorbidity, lower use of recommended HF therapies, longer length of stay (10.8 ± 10.1 vs. 9.7 ± 7.9 days), and higher in-hospital and 1-year mortality (32 vs. 25.8%) with no significant differences in readmission rates and lower 1-year re-ED visit rate. Hospitalized sHF patients had higher total costs (€12,262,422 vs. €9,144,952, p < 0.001), mean cost per patient-year (€9,755 ± 13,395 vs. €8,887 ± 12,059), and average daily cost per patient. Hospitalized sHF patients have a worse initial prognosis, greater use of healthcare resources, and higher costs.This study was an investigator-initiated initiative sponsored and supported by the grant from AstraZeneca Spain. LV receives research funding from the Instituto de Salud Carlos III, Spain (CM20/00104). GM is supported by a pre-doctoral grant by the Spanish Ministry of Education (FPU18/03606).S

Colorectal video-assisted surgery in Uruguay, after 106 cases

Marcelo Viola Malet: Clínica Quirúrgica “B”. Facultad de Medicina. Universidad de la República, Uruguay.-- Marcelo Laurini: Clínica Quirúrgica “3”. Facultad de Medicina. Universidad de la República, Uruguay.-- Justino Zeballos: Clínica Quirúrgica “B”. Facultad de Medicina. Universidad de la República, Uruguay.-- Nicolás Muniz: Clínica Quirúrgica “B”. Facultad de Medicina. Universidad de la República, Uruguay.-- Pablo Rodríguez Goñi: Clínica Quirúrgica “F”. Facultad de Medicina. Universidad de la República, Uruguay.-- Fernando Castelli: . Clínica Quirúrgica “A”. Facultad de Medicina. Universidad de la República, Uruguay.-- Gustavo Sánchez: Clínica Quirúrgica “2”. Facultad de Medicina. Universidad de la República, Uruguay.-- César Canessa: Clínica Quirúrgica “B”. Facultad de Medicina. Universidad de la República, Uruguay.-- Humberto Viola: Departamento de Cirugía, MUCAM, Montevideo, Uruguay. Contacto: Marcelo Viola Malet. E-mail: [email protected] advenimiento de la cirugía laparoscópica ha tenido un gran impacto en la cirugía gastrointestinal en los últimos 20 años. En particular la cirugía laparoscópica colorrectal es sin dudas el desarrollo técnico más importante en la cirugía de colon y recto de los últimos 15 años, y probablemente tendrá un impacto significativo en la formación quirúrgica y en los resultados de esta cirugía. En este trabajo intentamos reflejar nuestra experiencia en la cirugía laparoscópica colorrectal refiriéndonos a los aspectos fundamentalmente técnicos, el instrumental y nuestros resultados a corto y mediano plazo con este tipo de abordaje para la patología colorrectal. Contamos con experiencia en 106 casos de cirugía colorrectal laparoscópica, 63 hombres y 43 mujeres, desde noviembre de 2007 hasta marzo de 2014. En los últimos 4 años se operaron un promedio de 22 pacientes por año. Nuestra serie presentó un índice de falla de sutura del 4.72% y una mortalidad operatoria del 3.7%. El seguimiento promedio de los pacientes fue de 22 meses, con un mínimo de 1 y un máximo de 59 meses. La sobrevida global de la serie fue de 96.9%, con una media de sobrevida de 56.8 meses (IC: 54.3 – 59.2 meses); y una sobrevida libre de enfermedad de 90.7%, con una media de tiempo libre de la enfermedad de 52.2 meses (IC: 48.2 -56.3 meses). La cirugía laparoscópica colorrectal es factible y segura, con cifras de morbimortalidad similares a las presentadas en series a nivel mundial, tanto en cirugía laparoscópica como laparotómica, así como en la radicalidad oncológica de las resecciones.The advent of laparoscopic surgery has had a huge impact on gastrointestinal surgery in the past 20 years. Laparoscopic colorectal surgery is undoubtedly the most important technical development of the past 15 years, and will very likely have a significant impact on surgical training and on the results of this surgery. In recent years, significant events have happened in the history of surgery that have led us to develop new concepts, new terms, and different ways of performing the same techniques. In this paper we try to show our experience in laparoscopic colorectal surgery, mainly referring to the technical aspects, tools and our results in the short and medium term with this type of approach for colorectal disease. We have done 106 laparoscopic colorectal surgeries, 63 men and 43 women were operated since November 2007 to March 2014. In the last 4 years an average of 22 patients were operated per year. Our series presents a suture failure rate of 4.72% and an operative mortality of 3.7%. The average patient follow-up was 22 months, with a minimum of 1 and a maximum of 59 months. Overall survival in the series was 96.9%, with a median survival of 56.7 months (CI: 54.3 to 59.2 months) and disease free survival of 90.7% with a half off due to illness 52.2 months (CI: 48.2 to 56.3 months). Laparoscopic colorectal surgery is feasible and safe, with figures similar to those presented in series worldwide, both in laparotomic and laparoscopic surgery, as well as in cancer morbidity radical resections

Sex differences in patterns of referral and resource utilization in the cardiology clinic: an outpatient analysis

AimsWomen may have different management patterns than men in specialised care. Our aim was to assess potential sex differences in referral, management and outcomes of patients attending outpatient cardiac consultations.Methods and resultsRetrospective observational analysis of patients ≥18 years referred for the first time from primary care to a tertiary hospital cardiology clinic in 2017–2018, comparing reasons for referral, decisions and post-visit outcomes by sex.A total of 5,974 patients, 2,452 (41.0%) men aged 59.2 ± 18.6 years and 3,522 (59.0%) women aged 64.5 ± 17.9 years (P &lt; 0.001) were referred for a first cardiology consultation. The age-related referral rates were higher in women. The most common reasons for consultation were palpitations in women (n = 676; 19.2%) and ECG abnormalities in men (n = 570; 23.2%). Delays to cardiology visits and additional tests were similar. During 24 months of follow-up, women had fewer cardiology hospitalisations (204; 5.8% vs. 229; 9.3%; P = 0.003) and lower mortality (65; 1.8% vs. 66; 2.7%; P = 0.028), but those aged &lt;65 years had more emergency department visits (756; 48.5% vs. 560; 39.9%, P &lt; 0.001) than men.ConclusionThere are substantial sex differences in primary care cardiology referral patterns, including causes, rates, decisions and outcomes, which are only partially explained by age differences. Further research is needed to understand the reasons for these differences

Determinants of adherence to the mediterranean diet in Spanish children and adolescents: the PASOS Study

A progressive shift away from traditional healthy dietary patterns, such as the Mediterranean diet (MedDiet), has been observed in recent decades. The aim of this study was to assess determinants of optimal adherence to the MedDiet in Spanish children and adolescents. A cross-sectional analysis was included in the PASOS nationwide representative study in Spain. Participants were 3607 children and adolescents; 8–16 years old. Primary and secondary outcome measures of weight and height were measured. Adherence to the MedDiet, physical activity, and sedentary behavior in children and adolescents, as well as parental physical activity and dietary habits, were assessed. Optimal adherence to the MedDiet was observed in 45.5% of primary school students and 34.8% of secondary school students (OR: 0.65; 95%CI: 0.56–0.75). Optimal adherence to the MedDiet was higher in children/adolescents meeting daily recommended moderate and vigorous physical activity (OR: 2.39, 95%CI: 1.97–2.89) and in those meeting daily recommended screen time on week-days (OR: 2.05, 95%CI: 1.77–2.38) and weekends (OR: 1.76, 95%CI: 1.48–2.10). Participants with optimal adherence to the MedDiet were more likely to have mothers with a high-level education and high-tercile of SDQS, mothers who never smoked or were former smokers, and mothers who met the recommended physical activity and screen time. It can be concluded that a low prevalence of optimal adherence to the MedDiet was found among current Spanish children and adolescents. Optimal adherence to the MedDiet was associated with reaching the recommendations on physical activity and screen time, with the highest maternal educational level, and healthier maternal life-styles.The PASOS study was funded by Fundación PROBITAS and the Gasol Foundation. Additional funds were received from the Barça Foundation, Banco Santander, IFA, Vienna and the Fundación Deporte Joven (no references are applicable). J.A.T., C.B., M.M.G., and M.M.B. were funded by CIBEROBN (CB12/03/30038) of the Institute of Health Carlos III (ISCIII), and co-funded by the European Regional Development Fund

Spatial dynamics and mixing of bluefin tuna in the Atlantic Ocean and Mediterranean Sea revealed using next generation sequencing

The Atlantic bluefin tuna is a highly migratory species emblematic of the challenges associated with shared fisheries management. In an effort to resolve the species’ stock dynamics, a genomewide search for spatially informative single nucleotide polymorphisms (SNPs) was undertaken, by way of sequencing reduced representation libraries. An allele frequency approach to SNP discovery was used, combining the data of 555 larvae and young-of-the-year (LYOY) into pools representing major geographical areas and mapping against a newly assembled genomic reference. From a set of 184,895 candidate loci, 384 were selected for validation using 167 LYOY. A highly discriminatory genotyping panel of 95 SNPs was ultimately developed by selecting loci with the most pronounced differences between western Atlantic and Mediterranean Sea LYOY. The panel was evaluated by genotyping a different set of LYOY (n = 326), and from these, 77.8% and 82.1% were correctly assigned to western Atlantic and Mediterranean Sea origins, respectively. The panel revealed temporally persistent differentiation among LYOY from the western Atlantic and Mediterranean Sea (FST = 0.008, p = .034). The composition of six mixed feeding aggregations in the Atlantic Ocean and Mediterranean Sea was characterized using genotypes from medium (n = 184) and large (n = 48) adults, applying population assignment and mixture analyses. The results provide evidence of persistent population structuring across broad geographic areas and extensive mixing in the Atlantic Ocean, particularly in the mid-Atlantic Bight and Gulf of St. Lawrence. The genomic reference and genotyping tools presented here constitute novel resources useful for future research and conservation efforts

Escuela secundaria posible

REPENSAR LA EDUCACIÓN SECUNDARIA Colección de infografías II Parte Seguimiento de medios de comunicación 2017-2019Fil: Ferreyra, Horacio Ademar. Universidad Católica de Córdoba. Facultad de Educación; ArgentinaFil: Di Francesco, Adriana Carlota. Universidad Católica de Córdoba. Facultad de Educación; ArgentinaFil: Equipo de investigación en educación de adolescentes y jóvenes. Unidad Asociada CONICET. Universidad Católica de Córdoba. Facultad de Educación; Argentina