Statistical diagnosis of the internal control in a hospital institution

Introduction: Corporate organizations, specifically those related with public health, as budgeted units, are called to work with the goal of improve their internal control system, being determinant for the betterment of their results, as well as for the increase of the efficiency and satisfaction of the population. Objective: To diagnose the internal control management in a hospital entity belonging to Holguin’s province, Cuba, with the purpose of contribute to its improvement. Material and Methods: Application of the Solving Problems General Method supported by statistical analysis with the help of professional software.Results: The identification of existing deficiencies in the application of the rules to the components of the internal control system, and also the preparation of a strategy aimed to the improvement of this system in the hospital. Conclusions: A set of strategic actions was identified by areas’ clusters in the hospital, which contribute to solve the deficiencies found, prioritizing those related to integrity and ethical values, organizational structure, information and communications technology, content, quality, responsibility and accountability. Keywords: Internal control, hospital entity, Solving Problems General Method, statistical analysis.</p

Análisis de cadena de producción en rubro coco (Cocos nucifera L.), San Juan de Nicaragua

El estudio tiene como objetivo analizar el funcionamiento de los eslabones de la cadena de producción del rubro coco en San Juan de Nicaragua. Para esto se aplicó la metodología de cadenas de producción, usando una muestra por conveniencia con 48 actores que conforman los distintos eslabones logrando identificar que hay una limitada relación entre los eslabones de la cadena de producción, generando una dificultad en la interacción del funcionamiento de estos. Los eslabones que más se relacionan son el eslabón transformación y comercialización debido a que cuentan con una comunicación interactiva logrando generar buenas ganancias entre ellos, a diferencia del eslabón producción que no tiene una relación directa con ninguno de los demás eslabones esto debido a que estos se encargan de vender su producto. Los actores que forman parte del eslabón transformación se encargan de brindar valor agregado al producto estrella del municipio (coco) realizando distintos productos como aceite de coco, harina de coco y jabón de coco, siendo estos dos últimos productos parte de una iniciativa de un grupo de representantes étnicos del territorio que planean la creación de una cooperativa, logrando incursionar en nuevos mercados para generar más ingresos. La cantidad de producción tanto de materia prima como de productos a base de coco encontrados en los eslabones producción y transformación no es lo suficiente para cumplir con la demanda que exige su mercado. Los canales de comercialización utilizados por los actores son tanto directos como indirectos; logrando que el producto que ofrecen llegue a un mayor número de consumidores y no se centralice en un solo consumido, permitiendo mejorar considerablemente los ingresos de los actores que hacen parte de los eslabones, además de reducir el desperdicio de elementos del coco que no son utilizados y de esta manera contribuir a la mejora del funcionamiento de la cadena

Identification of Genes Responsive to Solar Simulated UV Radiation in Human Monocyte-Derived Dendritic Cells

Ultraviolet (UV) irradiation has profound effects on the skin and the systemic immune system. Several effects of UV radiation on Dendritic cells (DCs) functions have been described. However, gene expression changes induced by UV radiation in DCs have not been addressed before. In this report, we irradiated human monocyte-derived DCs with solar-simulated UVA/UVB and analyzed regulated genes on human whole genome arrays. Results were validated by RT-PCR and further analyzed by Gene Set Enrichment Analysis (GSEA). Solar-simulated UV radiation up-regulated expression of genes involved in cellular stress and inflammation, and down-regulated genes involved in chemotaxis, vesicular transport and RNA processing. Twenty four genes were selected for comparison by RT-PCR with similarly treated human primary keratinocytes and human melanocytes. Several genes involved in the regulation of the immune response were differentially regulated in UVA/UVB irradiated human monocyte-derived DCs, such as protein tyrosine phosphatase, receptor type E (PTPRE), thrombospondin-1 (THBS1), inducible costimulator ligand (ICOSL), galectins, Src-like adapter protein (SLA), IL-10 and CCR7. These results indicate that UV-exposure triggers the regulation of a complex gene repertoire involved in human-DC–mediated immune responses

Proposta de avaliação da gestão de risco do COVID-19 com abordagem difusa

Introduction: the confrontation with COVID-19 imposes important challenges on health professionals related to the health care of the population and to the prevention and control of infections in the community and in health institutions. One of the biggest challenges that hospitals face is managing their risk more efficiently without this deteriorating the quality perceived by the patient and healthcare personnel.Objective: assessing the management of epidemiological risk related to COVID-19 in healt councils and units.Methods: compensatory fuzzy logic was used as a pertinent method of mathematical modeling in complex processesResults: there is a decision model for the assessment of risk management related to COVID-19, integrated into the hospital internal control systemConclusions: the relevance of risk management as an alternative to exterminate the pandemic caused by the new coronavirus SARS CoV-2 was demonstrated. The pertinence of diffuse compensatory logic for decision making in complex processes is confirmed. The risk management of de covid was integrated into the hospital internal control system, allowing the desing of strategies for the improvement of health entities. Introducción: el enfrentamiento a la COVID-19 impone importantes retos a los profesionales de la salud relacionados con los cuidados de la salud de la población y con la prevención y control de infecciones en la comunidad y en las instituciones de salud. Uno de los mayores retos a los que se enfrentan los hospitales es gestionar los riesgos sin que ello suponga un deterioro de la calidad percibida por el paciente y personal sanitario.Objetivo: diseñar un modelo para la gestión de riesgos epidemiológicos relacionado con la COVID-19 en consejos y unidades de salud.Métodos: se utilizó la Lógica Difusa Compensatoria como método pertinente de la modelación matemática en procesos complejos.Resultados: se tiene un modelo de decisión para la valoración de la gestión de riesgos relacionado con la COVID-19, integrado al sistema de control interno hospitalario.Conclusiones: se demostró la pertinencia de la gestión de riesgos como alternativa para exterminar la pandemia causada por el nuevo Coronavirus SARS CoV-2. Se confirma la pertinencia de la lógica difusa compensatoria para la toma de decisiones en proceso complejos. Se integró la gestión de riesgos de la COVID-19 al sistema de control interno hospitalario, permitiendo tomar estrategias para la mejora de las entidades de la salud. Introdução: o enfrentamento da COVID-19 impõe desafios importantes para os profissionais de saúde relacionados à atenção à saúde da população e à prevenção e controle de infecções na comunidade e nas instituições de saúde. Um dos maiores desafios que os hospitais enfrentam é gerenciar os riscos sem causar uma deterioração na qualidade percebida pelo paciente e profissionais de saúde.Objetivo: traçar um modelo de gestão dos riscos epidemiológicos relacionados ao COVID-19 em conselhos e unidades de saúde.Métodos: A Lógica Fuzzy Compensatória foi utilizada como um método pertinente de modelagem matemática em processos complexos.Resultados: existe um modelo de decisão para avaliação do gerenciamento de riscos relacionado ao COVID-19, integrado ao sistema de controle interno do hospital.Conclusões: ficou demonstrada a relevância do gerenciamento de risco como alternativa para exterminar a pandemia causada pelo novo Coronavírus SARS CoV-2. A relevância da lógica fuzzy compensatória para a tomada de decisão em processos complexos é confirmada. A gestão de riscos do COVID-19 foi integrada ao sistema de controle interno do hospital, permitindo a adoção de estratégias de melhoria das entidades de saúde. 

Apicoformación en una pieza dentaria permanente joven con rehabilitación

El mantenimiento de las piezas dentarias en correcto estado, es uno de los objetivos que busca la Odontopediatría, considerándolo fundamental para el normal desarrollo y crecimiento del niño. Para ello, debe realizarse un plan de tratamiento acorde a las condiciones individuales del paciente, basándonos en un examen clínico y radiográfico correcto, de manera que siempre que sea factible, mantener no solo los dientes permanentes, sino también los primarios. En el presente caso clínico, la paciente concurrió a la consulta con múltiples lesiones cariosas, a las cuales se le realizó el tratamiento operatorio adecuado. Aquellas que presentaron mayor destrucción fueron tratadas quirúrgicamente con la posterior colocación del mantenedor de espacio. Una de las mayores preocupaciones, era la les ión cariosa de la pieza 2.4, presentando pulpa vital y con ápice abierto, por lo que se consideró la posibilidad de realizar un tratamiento de pulpotomía con MTA, a fin de producir un cierre por apexogenesis y una restauración que permitiera la conservación de la mis ma. El éxito de una restauración aumenta proporcionalmente a la edad del paciente, por ello es importante permitir la formación radicular en longitud y grosor para luego realizar la restauración definitiva.The maintenance of teeth in correct condition is one of the goals sought by Pediatric Dentistry, considering it essential for the normal development and growth of the child, for it must be made a treatment plan according to the individual conditions of the patient, based on a Clinical and radiographic examination, so that it is feasible to try to maintain not only the permanent but also the primary teeth. In the present clinical case, the patient attended the consultation with multiple carious lesions to which the appropriate operative treatment was performed, those that presented greater destruction were treated surgically with the posterior placement of the space maintainer, one of the major concerns was The carious lesion of part 2.4, being this permanent and with an open apex, would require a special consideration, which, when it was vital, revealed a pulpotomy with MTA in order to produce a closure by apexogenesis and a restoration that allowed the conservation of the Same. The success of a restoration increases proportionally to the age of the patient, so it is important to allow root formation in length and thickness and then perform the final restoration.Fil: Cardoso, María Lorena. Universidad Nacional del Nordeste. Facultad de Odontologia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: de la Vega, Maria Clara. Universidad Nacional del Nordeste. Facultad de Odontologia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Meza, Cinthia. Universidad Nacional del Nordeste. Facultad de Odontologia; ArgentinaFil: Gonzalez, Maria de Jesus. Universidad Nacional del Nordeste. Facultad de Odontologia; ArgentinaFil: Galiana, Andrea Verónica. Universidad Nacional del Nordeste. Facultad de Odontologia; Argentin

Multi-Species Transcriptome Assemblies of Cultivated and Wild Lentils (Lens sp.) Provide a First Glimpse at the Lentil Pangenome

[EN] Lentils (Lens sp.) are one of the main sources of protein for humans in many regions, in part because their rusticity allows them to withstand semi-dry climates and tolerate a wide spectrum of pests. Both are also highly sought-after attributes to face climate change. Wild accessions, rather than cultivated varieties, are typically the holders of most influential alleles for rusticity traits. However, most genomic and transcriptomic research conducted in lentils has been carried out on commercial accessions (L. culinaris), while wild relatives have been largely neglected. Herein, we assembled, annotated, and evaluated the transcriptomes of eight lentil accessions, including the cultivated Lens culinaris and the wild relatives: L. orientalis, L. tomentosus, L. ervoides, L. lamottei, L. nigricans, and two L. odemensis. The assemblies allowed, for the first time, a comparison among different lentil taxa at the coding sequence level, providing further insights into the evolutionary relationships between cultivated and wild germplasm and suggesting a grouping of the seven accessions into at least three conceivable gene pools. Moreover, orthologous clustering allowed a first estimation of the lentil pan-transcriptome. It is composed of 15,910 core genes, encoded in all accessions, and 24,226 accessory genes. The different pan-transcriptome clusters were also screened for Pfam-domain enrichment. The present study has a high novelty, as it is the first pan-transcriptome analysis using six wild species in addition to cultivated species. Because of the amount of transcript sequences provided, our findings will greatly boost lentil research and assist breeding efforts.S

Accuracy of liquid-based brush cytology and HPV detection for the diagnosis and management of patients with oropharyngeal and oral cancer.

Objectives This study aims to evaluate the usefulness of liquid-based brush cytology for malignancy diagnosis and HPV detection in patients with suspected oropharyngeal and oral carcinomas, as well as for the diagnosis of tumoral persistence after treatment. Material and methods Seventy-five patients with suspicion of squamous cell carcinoma of the oropharynx or oral cavity were included. Two different study groups were analyzed according to the date of the sample collection: (1) during the first endoscopy exploration and (2) in the first control endoscopy after treatment for squamous cell carcinoma. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for malignancy diagnosis as well as for HPV-DNA detection on brush cytologies were assessed. Results Before treatment, the brush cytology showed a sensitivity of 88%, specificity of 100%, and accuracy of 88%. After treatment, it showed a sensitivity of 71%, specificity of 77%, and accuracy of 75%. HPV-DNA detection in cytology samples showed a sensitivity of 85%, specificity of 100%, and accuracy of 91% before treatment and an accuracy of 100% after treatment. Conclusions Liquid-based brush cytology showed good accuracy for diagnosis of oropharyngeal and oral squamous cell carcinoma before treatment, but its value decreases after treatment. Nevertheless, it is useful for HPV-DNA detection, as well as to monitor the patients after treatment. Clinical relevance Brush cytology samples are reliable for the detection of HPV-DNA before and after treatment and may be a useful method to incorporate in the HPV testing guidelines