E-learning y oficinas virtuales durante la pandemia del Covid-19

The Covid 19 pandemic has triggered worldwide the implementation of strategies that help to do at home what is normally done in a work office and in a classroom, this as a consequence of quarantine and isolation, which has caused the closure of non-essential businesses and shops, universities, schools and high schools. The research methodology is of a bibliographic review type. The general conclusions reached in the research is that each country, based on its circumstances, has applied the best available strategies to avoid a collapse in its educational and production systems, encouraging work from home, either as education. remote or telework. However, up to the date of this research, there were no real world figures by region for the number of people who are doing work and homeschooling, more than anything they are estimates, the information has to be collected by country and then aggregated. Another conclusion is that there cannot be a job and distance education, if internet access is limited in the countries, if there are not enough mobile lines for every x number of people and of course the ability of people to acquire them.La pandemia del Covid 19 ha desencadenado a nivel mundial la implementación de estrategias que ayuden a hacer en casa lo que normalmente se hace en una oficina de trabajo y en un aula de clase, esto como consecuencia de la cuarentena y el aislamiento, que ha provocado el cierre de empresas y comercios no esenciales, universidades, escuelas y liceos. La metodología de la investigación es de tipo revisión bibliográfica. Las conclusiones generales a las que se llegan en la investigación, es que cada país, en base a sus circunstancias ha aplicado las mejores estrategias disponibles para evitar un colapso en sus sistemas educativos y de producción, incentivando el trabajo desde casa, ya sea como educación a distancia o tele trabajo. Sin embargo hasta la fecha de esta investigación no había cifras mundiales reales por región de la cantidad de personas que están haciendo trabajo y educación en casa, más que todo son estimaciones, la información tiene que ser recabada por país para luego ser totalizada. Otra conclusión es que no puede haber un trabajo y educación a distancia, si el acceso a internet es limitado en los países, si no hay líneas móviles suficientes por cada x cantidad de personas y por supuesto la capacidad de las personas para adquirirlos

Iontoforesis con pilocarpina; un método de administración de corriente continua para evitar dolor y quemaduras

La iontoforesis con pilocarpina, es una técnica de estimulación de las glándulas sudoríparas aplicada en el estudio denominado “Test del sudor”, propuesto por L. E. Gibson y R. E. Cooke, para el diagnóstico de la fibrosis quística. En especial la iontoforesis con corriente contínua, actualmente esta muy difundida en diversos tratamientos y estudios, con el fin de introducir medicamentos a través de la piel. Analizaremos su relación con los efectos indeseados de quemaduras y dolor sobre el paciente y el instrumento desarrollado para este estudio. Este trabajo presenta un estudio realizado sobre los efectos de la iontoforesis y la manera de evitarlos mediante la administración controlada de corriente. Además, se analiza el proceso de automatización y la técnica de transferencia de datos desarrollados para este trabajo.Sociedad Argentina de Informática e Investigación Operativ

Diálogos Insurgentes entre Educação Ambiental e Culturas no Encontro Pesquisa em Educação Ambiental (EPEA)

This article aims to reflect on the theme Environmental Education and Cultures with an emphasis on the works presented since the first Research Meeting in Environmental Education in 2001 until the reflections that occurred in the Research Discussion Group of this research subfield, during the X EPEA of the year 2019. In addition to bringing an account of the discussions, the article focuses on the evolution of the themes of works related to cultures, presented in the first four editions of EPEA (2001-2007), in a modest state of art made using search terms related to the theme, present in their abstracts. We found that, during this period, investigations were, predominantly, linked to the categories of culture and knowledge, which were covered by works in all editions. The themes of Cultural Studies, Inter/multiculturality and Coloniality were not present in the investigations of this subfield presented at the EPEA, in the period, being necessary to deepen the extension of this phenomenon in magazines and databases of dissertations and theses, as well as to evaluate the epistemological and sociopolitical developments of the attention that has been given by the field of research in Environmental Education to the perspectives that recognize and give voice to different cultures, aiming to overcome the silencing processes that prevent full participation in decision-making processes and in social life. Such themes have recently appeared in GDP EA and Culturas that value dialogicity and inter/multiculturality, with criticisms of coloniality and expanding the epistemological, political-methodological and ontological possibilities of Environmental Education Research.Este artículo tiene como objetivo reflexionar sobre el tema Educación Ambiental y Culturas, con énfasis en los trabajos presentados desde la primera Reunión de Investigación en Educación Ambiental, en 2001, hasta las reflexiones que ocurrieron en el Grupo de Discusión de Investigación de este subcampo de investigación, durante el X EPEA del año 2019. Además de dar cuenta de las discusiones, el artículo se centra en la evolución de los temas de las obras relacionadas con las culturas, presentadas en las primeras cuatro ediciones de EPEA (2001-2007), en un estado modesto de arte realizado utilizando términos de búsqueda relacionados con el tema, presente en sus resúmenes. Descubrimos que, durante este período, las investigaciones estaban predominantemente vinculadas a las categorías de cultura y conocimiento, que estaban cubiertas por obras en todas las ediciones. Los temas de Estudios Culturales, Inter/multiculturalidad y Colonialidad no estuvieron presentes en las investigaciones de este subcampo presentado en el EPEA, en el período, siendo necesario profundizar la extensión de este fenómeno en revistas y bases de datos de disertaciones y tesis, así como evaluar los desarrollos epistemológicos y sociopolíticos de la atención que ha brindado el campo de la investigación en Educación Ambiental a las perspectivas que reconocen y dan voz a las diferentes culturas, con el objetivo de superar los procesos de silenciamiento que impiden la plena participación en los procesos de toma de decisiones y en la vida social. Tales temas han aparecido recientemente en GDP EA y Culturas que valoran la dialogicidad y la inter/multiculturalidad, con críticas a la colonialidad y ampliando las posibilidades epistemológicas, político-metodológicas y ontológicas de la Investigación en Educación Ambiental.Este artigo tem por objetivo refletir sobre a temática Educação Ambiental e Culturas, com ênfase nos trabalhos apresentados desde o primeiro Encontro Pesquisa em Educação Ambiental (EPEA), em 2001, até as reflexões ocorridas no Grupo de Discussão de Pesquisas (GDP) desse subcampo de pesquisa, durante o X EPEA, realizado em 2019. Para além de trazer um relato das discussões, o artigo se debruça sobre a evolução das temáticas dos trabalhos relacionados às culturas, apresentados nas quatro primeiras edições do EPEA (2001-2007), em um modesto estado da arte realizado por meio de termos de busca ligados à temática, presentes em seus resumos. Constatamos que, nesse período, as investigações estavam ligadas predominantemente às categorias cultura e saberes, que foram contempladas por trabalhos em todas as edições. Os temas dos Estudos Culturais, Inter/ multiculturalidade e Colonialidade não estiveram presentes nas investigações desse subcampo apresentadas no EPEA, no período, sendo necessário aprofundar a extensão desse fenômeno em revistas e bancos de dissertações e teses, bem como avaliar os desdobramentos epistemológicos e sociopolíticos da atenção que tem sido conferida pelo campo da pesquisa em Educação Ambiental às perspectivas que reconhecem e conferem a voz às diferentes culturas, visando superar os processos de silenciamento que impedem a participação plena nos processos decisórios e na vida social. Temáticas tais que aparecem recentemente no GDP EA e Culturas que valorizam a dialogicidade e a inter/multiculturalidade, com críticas à colonialidade e ampliando as possibilidades epistemológicas, político-metodológicas e ontológicas da Pesquisa em Educação Ambiental

Un examen actualizado de la percepción de las barreras para la implementación de la farmacogenómica y la utilidad de los pares fármaco/gen en América Latina y el Caribe

La farmacogenómica (PGx) se considera un campo emergente en los países en desarrollo. La investigación sobre PGx en la región de América Latina y el Caribe (ALC) sigue siendo escasa, con información limitada en algunas poblaciones. Por lo tanto, las extrapolaciones son complicadas, especialmente en poblaciones mixtas. En este trabajo, revisamos y analizamos el conocimiento farmacogenómico entre la comunidad científica y clínica de ALC y examinamos las barreras para la aplicación clínica. Realizamos una búsqueda de publicaciones y ensayos clínicos en este campo en todo el mundo y evaluamos la contribución de ALC. A continuación, realizamos una encuesta regional estructurada que evaluó una lista de 14 barreras potenciales para la aplicación clínica de biomarcadores en función de su importancia. Además, se analizó una lista emparejada de 54 genes/fármacos para determinar una asociación entre los biomarcadores y la respuesta a la medicina genómica. Esta encuesta se comparó con una encuesta anterior realizada en 2014 para evaluar el progreso en la región. Los resultados de la búsqueda indicaron que los países de América Latina y el Caribe han contribuido con el 3,44% del total de publicaciones y el 2,45% de los ensayos clínicos relacionados con PGx en todo el mundo hasta el momento. Un total de 106 profesionales de 17 países respondieron a la encuesta. Se identificaron seis grandes grupos de obstáculos. A pesar de los continuos esfuerzos de la región en la última década, la principal barrera para la implementación de PGx en ALC sigue siendo la misma, la "necesidad de directrices, procesos y protocolos para la aplicación clínica de la farmacogenética/farmacogenómica". Las cuestiones de coste-eficacia se consideran factores críticos en la región. Los puntos relacionados con la reticencia de los clínicos son actualmente menos relevantes. Según los resultados de la encuesta, los pares gen/fármaco mejor clasificados (96%-99%) y percibidos como importantes fueron CYP2D6/tamoxifeno, CYP3A5/tacrolimus, CYP2D6/opioides, DPYD/fluoropirimidinas, TMPT/tiopurinas, CYP2D6/antidepresivos tricíclicos, CYP2C19/antidepresivos tricíclicos, NUDT15/tiopurinas, CYP2B6/efavirenz y CYP2C19/clopidogrel. En conclusión, aunque la contribución global de los países de ALC sigue siendo baja en el campo del PGx, se ha observado una mejora relevante en la región. La percepción de la utilidad de las pruebas PGx en la comunidad biomédica ha cambiado drásticamente, aumentando la concienciación entre los médicos, lo que sugiere un futuro prometedor en las aplicaciones clínicas de PGx en ALC.Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers based on their importance. In addition, a paired list of 54 genes/drugs was analyzed to determine an association between biomarkers and response to genomic medicine. This survey was compared to a previous survey performed in 2014 to assess progress in the region. The search results indicated that Latin American and Caribbean countries have contributed 3.44% of the total publications and 2.45% of the PGx-related clinical trials worldwide thus far. A total of 106 professionals from 17 countries answered the survey. Six major groups of barriers were identified. Despite the region’s continuous efforts in the last decade, the primary barrier to PGx implementation in LAC remains the same, the “need for guidelines, processes, and protocols for the clinical application of pharmacogenetics/pharmacogenomics”. Cost-effectiveness issues are considered critical factors in the region. Items related to the reluctance of clinicians are currently less relevant. Based on the survey results, the highest ranked (96%–99%) gene/drug pairs perceived as important were CYP2D6/tamoxifen, CYP3A5/tacrolimus, CYP2D6/opioids, DPYD/fluoropyrimidines, TMPT/thiopurines, CYP2D6/tricyclic antidepressants, CYP2C19/tricyclic antidepressants, NUDT15/thiopurines, CYP2B6/efavirenz, and CYP2C19/clopidogrel. In conclusion, although the global contribution of LAC countries remains low in the PGx field, a relevant improvement has been observed in the region. The perception of the usefulness of PGx tests in biomedical community has drastically changed, raising awareness among physicians, which suggests a promising future in the clinical applications of PGx in LAC

PhDay Educación 2020. VI Jornadas de Investigación. Libro de Actas

Todas las contribuciones presentadas en este Libro de Actas forman parte de la evaluación de seguimiento de los doctorandos de segundo año a tiempo completo y tercer año a tiempo parcial del Programa de Doctorado en Educación de la Universidad Complutense de Madrid. Cada trabajo ha sido revisado formalmente por el comité organizador y valorado por los directores y tutores de tesis. Asimismo, cada doctorando ha recibido mejoras por otros estudiantes del programa que han podido incluir antes de la finalización del presente documento

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure &lt; 100 mmHg (n = 1127), estimated glomerular filtration rate &lt; 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation