Photonic systems for tunable mm-wave and THz wireless communications

In this paper we present two different techniques for photonic generation of millimeter and THz waves. Each of them tackles the phase noise problem associated with optical sources in a different way. The first one relays on the heterodyne down-conversion of two phase noise correlated optical tones. The correlation is achieved by generation of an optical frequency comb. To select one of the optical lines we use an optical phase lock loop, which besides enabling a frequency offset between output and input, can provide optical gain and is highly selective. The second one relays on the envelope detection of a single sideband-with carrier signal. In this approach the photonic remote antenna unit is implemented as monolithically integrated photonic chip

Addressing the disparities in dementia risk, early detection and care in Latino populations: Highlights from the Second Latinos and Alzheimer's Symposium

The Alzheimer's Association hosted the second Latinos & Alzheimer's Symposium in May 2021. Due to the COVID-19 pandemic, the meeting was held online over 2 days, with virtual presentations, discussions, mentoring sessions, and posters. The Latino population in the United States is projected to have the steepest increase in Alzheimer's disease (AD) in the next 40 years, compared to other ethnic groups. Latinos have increased risk for AD and other dementias, limited access to quality care, and are severely underrepresented in AD and dementia research and clinical trials. The symposium highlighted developments in AD research with Latino populations, including advances in AD biomarkers, and novel cognitive assessments for Spanish-speaking populations, as well as the need to effectively recruit and retain Latinos in clinical research, and how best to deliver health-care services and to aid caregivers of Latinos living with AD

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

Integral intranet platform with cms for process centralization, communication and training in the business environment

El objetivo general del proyecto consiste en optimizar la centralización de información, comunicación y desarrollo formativo con la finalidad de mejorar la productividad de los colaboradores de la organización. En el planteamiento de esta investigación se logró identificar que el problema es la centralización de la información, comunicación y el deficiente desarrollo formativo debido a las diferentes plataformas que posee la organización e implicando mayor tiempo empleado para los diferentes trámites internos de la organización. Se planteó que, para mejorar la productividad de los trabajadores se necesitaba de una plataforma que centraliza los procesos mencionados. La metodología SCRUM fue aplicada es este proyecto porque permite implementar procesos en tiempos cortos. Adicionalmente se trabajó la arquitectura empresarial para identificar los procesos y las aplicaciones que están involucradas. Se utilizaron diagramas C4 para definir las diferentes interfaces del sistema. Mediante la técnica de encuestas que poseen un cuestionario con una puntuación que permite validar la aprobación de los 5 expertos que revisaron el sistema. Los resultados de las encuestas demostraron que el sistema cumple de manera exitosa en términos de seguridad, rendimiento, colaboración, usabilidad y formación. La conclusión principal fue un eficiente desarrollo basado en mejoras continuas con la aplicación de herramientas que permitan entender la relación de las interfaces, procesos y aplicaciones que interactúan con el sistema.The general objective of the project is to optimize the centralization of information, communication, and training development to enhance the productivity of the organization's employees. In the formulation of this research, it was identified that the problem lies in the decentralization of information, communication, and inadequate training development due to the various platforms that the organization possesses, resulting in increased time spent on internal organizational processes. It was proposed that to improve the productivity of the employees, a platform was needed to centralize the mentioned processes. The SCRUM methodology was applied in this project because it allows for the implementation of processes in short time frames. Additionally, enterprise architecture was worked on to identify the processes and applications that are involved. C4 diagrams were used to define the different system interfaces. Through a survey technique that includes a questionnaire with a scoring system, the approval of the system was validated by five experts who reviewed it. The survey results demonstrated that the system successfully fulfills the criteria of security, performance, collaboration, usability, and training. The main conclusion was an efficient development based on continuous improvement with the application of tools that allow an understanding of the relationship between interfaces, processes, and applications that interact with the system.Trabajo de Suficiencia Profesiona

Servicio de cuidado y tutoria para niños, Nanny House

Administración de EmpresasPresenta la empresa Nanny House, un servicio de cuidado y tutoría para niños. En donde los padres de familia podrán encontrar un apoyo que los ayude en la enseñanza de sus hijos. La propuesta surge de la idea de cubrir la necesidad que tienen los padres de familia de contratar a una persona idónea que se encargue de reforzar la parte académica de sus hijos, ayudándolos con el desarrollo de las tareas y los estudios. Actualmente la mayoría de padres de familia por motivos laborales no disponen de mucho tiempo para poder ayudar a sus hijos con sus tareas escolares o exámenes, haciendo que el poco tiempo libre que tienen padres e hijos lo dediquen a corregir tareas, hacer trabajos o estudiar. Es por ello que nuestro servicio busca solucionar este problema ayudando a los niños durante la semana para que cumplan con sus deberes escolares dedicando así el fin de semana a pasar momentos gratos en familia compartiendo tiempo de calidad y fortaleciendo vínculos. La Estrategia que aplicará la empresa será la de diferenciación, ya que nos distinguiremos de otros servicios de cuidado de niños por nuestro personal capacitado en educación y con experiencia en el manejo de niños. Nuestras colaboradoras no sólo reforzarán la parte cognitiva de los menores sino también inculcarán en ellos hábitos y valores que los ayudarán en su desarrollo personal. Esta estrategia será nuestra principal ventaja competitiva. Empezaremos nuestras operaciones dirigiéndonos al segmento B el cual cuenta con 14,581 niños. Se empezará brindando el servicio a 10 niños aproximadamente, siendo nuestros principales objetivos obtener un incremento del 17% en ventas de manera semestral por año y al segundo año incrementar en 30% el número de niños. Hemos estimado una inversión de S/. 12, 983, el 50% será por financiamiento y el 50% estará compuesto por el aporte de capital de los accionistas. Nuestra VAN está calculada en S/. 78, 000 y la TIR en 101%. Por los análisis realizados concluimos que nuestro proyecto es rentable y viable, siendo una oportunidad de negocio para los inversionistas.Trabajo de investigació