Effect of trade and regulatory policies on level users satisfaction of mobile phone service in Colombia

En esta investigación se identificó y cuantificó el efecto de las políticas legislativas, normativas y de comercio en el nivel de satisfacción de los usuarios del servicio de telefonía móvil en Colombia. Para ello se realizó un análisis de mercado y comercio de la telefonía móvil, así como de las políticas legislativas, normativas y de calidad y satisfacción de los usuarios del servicio en Colombia, para el periodo 2000-2012. Como resultado se formularon siete modelos matemáticos del nivel de satisfacción en el país y del segmento prepago y postpago de los tres operadores con mayor participación en el mercado, a través de tres factores como son las cifras de importaciones de teléfonos móviles, la cantidad de teléfonos homologados y la distribución del mercado entre operadores, y se estimaron los niveles no reportados por el regulador para el periodo 2010-2012, encontrando una tendencia constante cercana al 70%. Se concluye que en el mercado de la telefonía móvil existen efectos regulatorios adicionales a los medidos y declarados por regulador, los cuales limitan la garantía de un nivel mínimo de calidad del servicio como requisito de operación dentro del mercado. La presencia del factor de importación en todos los modelos refleja los efectos de la evolución del mercado sobre la satisfacción de los usuarios del servicio de telefonía móvil, dados por la implementación de nuevas tecnologías, la oferta de nuevos servicios y la participación de nuevos operadores.This research characterized and quantified the effect of the legislative policy, regulations, and trade policies in the level users satisfaction of the mobile phone service in Colombia. For this, we conducted a market and commerce analysis of mobile telephone, as well as legislative, regulatory, quality and satisfaction policies of service users in Colombia, for the period 2000-2012. As a result seven mathematical models were formulated of the level users satisfaction in Colombia and prepaid and postpaid segment of the three operators with greater market share, through three factors like value of importation of mobile phones, quantity of phones approved and market sharing between operators, levels not reported by regulator were estimated for the period 2010-2012 and a consistent trend of about 70% was discovered. We conclude that in the mobile phone market there are regulatory effects additional to the measured and reported by the regulator, which limit the guarantee of a minimum level of quality of service as an operational requirement within the market. The presence of the importation factor in all models reflects the effects of market evolution on the user satisfaction of mobile phone service, given by the implementation of new technologies, new services offers and the participation of new mobile phone operators

Guanosine inhibits hepatitis C virus replication and increases indel frequencies, associated with altered intracellular nucleotide pools

In the course of experiments aimed at deciphering the inhibition mechanism of mycophenolic acid and ribavirin in hepatitis C virus (HCV) infection, we observed an inhibitory effect of the nucleoside guanosine (Gua). Here, we report that Gua, and not the other standard nucleosides, inhibits HCV replication in human hepatoma cells. Gua did not directly inhibit the in vitro polymerase activity of NS5B, but it modified the intracellular levels of nucleoside di- and tri-phosphates (NDPs and NTPs), leading to deficient HCV RNA replication and reduction of infectious progeny virus production. Changes in the concentrations of NTPs or NDPs modified NS5B RNA polymerase activity in vitro, in particular de novo RNA synthesis and template switching. Furthermore, the Gua-mediated changes were associated with a significant increase in the number of indels in viral RNA, which may account for the reduction of the specific infectivity of the viral progeny, suggesting the presence of defective genomes. Thus, a proper NTP:NDP balance appears to be critical to ensure HCV polymerase fidelity and minimal production of defective genomes.CP is supported by the Miguel Servet program (grants CP14/00121 and CP19/00001) of the Instituto de Salud Carlos III cofinanced by FEDER. CP has received funding from Ministerio de Ciencia, Innovacio´n y Universidades (grant BFU2017-91384-EXP), from Instituto de Salud Carlos III (grants PI18/00210 and PI21/00139), from Fundación La Marato´ (grant 525/C/2021), and from CSIC (grant CSIC-COV19-014). ED has received funding from CIBERehd (Centro de Investigación en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III), from Ministerio de Economía y Competitividad (grants SAF2014-52400-R, SAF2017-87846-R, and PID2020-113888RB-I00), and from Comunidad de Madrid/FEDER (grants S2013/ABI-2906 PLATESA, and S2018/BAA-4370 PLATESA2). AM has received funding from Ministerio de Economía y Competitividad (grants SAF2016-80451-P, PID2019-106068GB-I00, EQC2018-004420-P, and EQC2018-004631-P), and Plan Propio of Universidad de Castilla-La Mancha. A.G-P and L.DM have received funding from Consejería de Transformación Económica, Industria, Conocimiento y Universidades, Junta de Andalucía, cofinanced by FEDER and FSE (grants BIO-264, and P10-CVI-6561) and Plan Propio of Universidad de Málaga.Peer reviewe

General Microbiota of the Soft Tick Ornithodoros turicata Parasitizing the Bolson Tortoise (Gopherus flavomarginatus) in the Mapimi Biosphere Reserve, Mexico

The general bacterial microbiota of the soft tick Ornithodoros turicata found on Bolson tortoises (Gopherus flavomarginatus) were analyzed using next generation sequencing. The main aims of the study were to establish the relative abundance of bacterial taxa in the tick, and to document the presence of potentially pathogenic species for this tortoise, other animals, and humans. The study was carried-out in the Mapimi Biosphere Reserve in the northern-arid part of Mexico. Bolson tortoises (n = 45) were inspected for the presence of soft ticks, from which 11 tortoises (24.4%) had ticks in low loads (1–3 ticks per individual). Tick pools (five adult ticks each) were analyzed through 16S rRNA V3–V4 region amplification in a MiSeq Illumina, using EzBioCloud as a taxonomical reference. The operational taxonomic units (OTUs) revealed 28 phyla, 84 classes, 165 orders, 342 families, 1013 genera, and 1326 species. The high number of taxa registered for O. turicata may be the result of the variety of hosts that this tick parasitizes as they live inside G. flavomarginatus burrows. While the most abundant phyla were Proteobacteria, Actinobacteria, and Firmicutes, the most abundant species were two endosymbionts of ticks (Midichloria-like and Coxiella-like). Two bacteria documented as pathogenic to Gopherus spp. were registered (Mycoplasma spp. and Pasteurella testudinis). The bovine and ovine tick-borne pathogens A. marginale and A. ovis, respectively, were recorded, as well as the zoonotic bacteria A. phagocytophilum,Coxiella burnetii, and Neoehrlichia sp. Tortoises parasitized with O. turicata did not show evident signs of disease, which could indicate a possible ecological role as a reservoir that has yet to be demonstrated. In fact, the defense mechanisms of this tortoise against the microorganisms transmitted by ticks during their feeding process are still unknown. Future studies on soft ticks should expand our knowledge about what components of the microbiota are notable across multiple host–microbe dynamics. Likewise, studies are required to better understand the host competence of this tortoise, considered the largest terrestrial reptile in North America distributed throughout the Chihuahuan Desert since the late Pleistocene

Nuevas tendencias en el diseño de materiales y estructuras

El presente texto incluye temas como las nuevas herramientas para la modelación de diferentes problemas relacionados con la Ingeniería Civil; la implantación de un modelo matemático para el análisis dinámico no lineal de las viviendas prefabricadas, que permite simular el comportamiento histerético del sistema estructural de la vivienda a partir del comportamiento cíclico experimental; las herramientas de la inteligencia artificial (las redes neuronales) para la modelación de fenómenos complejos presentes en el comportamiento de algunos materiales, en este caso en tres arenas típicas y su relación esfuerzo-deformación; nuevos enfoques en el diseño de estructuras y materiales, nuevas tendencias de diseño tanto de las estructuras como en los materiales compuestos; una perspectiva sobre nuevos materiales compuestos o alternativos, que proponen materiales de origen natural combinados con materiales tradicionales en la industria de la construcción. Presenta una breve descripción de los materiales compuestos, tipo sándwich, y propone un nuevo compuesto a partir de conglomerados de material vegetal y ferrocemento. E incluye el estudio de los suelos residuales estabilizados con cal y se evalúa su comportamiento mecánico.PRÓLOGO............. 15 PRESENTACIÓN.............. 17 Primera parte Nuevas herramientas para la modelación de problemas en Ingeniería Civil Capítulo 1 APLICACIÓN DEL MODELO DE Bouc y Wen EN EL ANÁLISIS SÍSMICO DE VIVIENDAS PREFABRICADAS Daniel Alveiro Bedoya Ruiz 1.1 INTRODUCCIÓN.............. 21 1.2 AVANCES EN EL MODELO DE Bouc y Wen............. 23 1.3 SISTEMAS HISTERÉTICOS NO LINEALES............ 27 1.3.1 Ecuación de movimiento............ 30 1.3.2 Parámetros de forma de la histéresis............ 31 1.3.3 Disipación de energía............. 34 1.3.4 Rigidez, resistencia y estrangulamiento..............35 1.4 Identificación de sistemas y control.............. 37 1.5 APLICACIÓN DEL MODELO EN VIVIENDAS PREFABRICADAS............. 38 1.5.1 El modelo en casas prefabricadas de ferrocemento............. 41 1.5.2 Dinámica y comportamiento no lineal............. 44 1.6 CONCLUSIÓN............ 45 Capítulo 2 DETERMINACIÓN DE LA RELACIÓN CONSTITUTIVA DE LAS ARENAS USANDO REDES NEURONALES ARTI FICIALES (RNA) Hernán Eduardo Martínez-Carvajal - Márcio Muniz de Farias 2.1 INTRODUCCIÓN............ 51 2.2 MODELAMIENTO CONSTITUTIVO DE MATERIALES........... 53 2.3 MODELAMIENTO CONSTITUTIVO USANDO REDES NEURONALES ARTIFICIALES............. 55 2.4 LA BASE DE DATOS............ 56 2.5 LA ARQUITECTURA DE LA RED NEURONAL............... 58 2.6 RESULTADOS DE LA SIMULACIÓN............. 60 2.7. CONCLUSIONES.............. 65 Segunda parte Nuevos enfoques en el diseño de materiales y estructuras Capítulo 3 Diseño por desplazamientos de pilares de puentes Matthew J. Tobolski - José I. Restrepo 3.1 INTRODUCCIÓN............ 69 3.2 ESPECTRO DEL DISEÑO............. 72 3.3 AMORTIGUAMIENTO............ 74 3.4 RESPUESTA INÉLASTICA............. 75 3.5 COMBINACIÓN DE FACTORES DE AMPLIFICACIÓN DE DESPLAZAMIENTO............. 79 3.6 CAPACIDAD DE DESPLAZAMIENTO............ 80 3.7 PROCEDIMIENTO DE DISEÑO............ 85 3.8 OBJETIVO DE DESEMPEÑO DE SEGURIDAD DE LA VIDA.............. 86 3.9 OBJETIVO DE DESEMPEÑO DE FUNCIONAMIENTO INMEDIATO.............. 89 3.10 DISEÑO DE LOS ELEMENTOS............. 92 3.11 ANÁLISIS PARAMÉTRICO............. 93 3.12 EXIGENCIA SÍSMICA Y DUCTILIDAD DE CURVATURA.............. 93 3.13 PROPORCIÓN DE LA ROTACIÓN RESIDUAL............. 94 3.14 DIÁMETRO Y ALTURA DE LA COLUMNA.............. 95 3.15 CONCLUSIONES.............. 98 3.16 APÉNDICE. EJEMPLO DE DISEÑO............... 99 Capítulo 4 UN NUEVO ENFOQUE PARA EL ANÁLISIS Y DISEÑO DE ESTRUCTURAS DE HORMIGÓN ARMADO Héctor Guillermo Urrego Giraldo 4.1 INTRODUCCIÓN.............. 111 4.2 COMPORTAMIENTO DEL HORMIGÓN............. 113 4.3 COMPORTAMIENTO DEL ACERO.............. 115 4.4 CURVATURA.............. 117 4.5 EJEMPLO 1.............. 123 4.6 MÉTODO PROPUESTO............... 136 4.7 EJEMPLO 2............. 138 4.8 CONCLUSIONES............... 144 Capítulo 5 DESEMPEÑO SÍSMICO DE PÓRTI COS PLANOS DE ACERO CON EL SISTEMA KNEE-BRACING Ricardo León Bonett Díaz - Carolina López Toro 5.1 INTRODUCCIÓN.............. 147 5.2 MARCO CONCEPTUAL.............. 149 5.3 CRITERIOS PARA ESCOGER EL KNEE Y EL BRACE.............. 151 5.4 CASO DE ESTUDIO............. 153 5.5 INCORPORACIÓN DEL DISPOSABLE KNEE BRACING............. 165 5.6 EVALUACIÓN DE LA CAPACIDAD SÍSMICA............. 167 5.7 ANÁLISIS DE RESULTADOS.............. 172 5.8 CONCLUSIONES................ 176 Capítulo 6 TENDENCIAS EN EL DISEÑO DE MEZCLAS ASFÁLTI CAS EN CALIENTE ¡MARSHALL vs SUPERPAVE! Carlos Rodolfo Marín Uribe 6.1 INTRODUCCIÓN.............. 179 6.2 DESCRIPCIÓN DE LAS METODOLOGÍAS DE DISEÑO............... 180 6.3 Algunas diferencias entre las dos metodologías.............. 190 6.4 DESARROLLO DE UN TRABAJO EXPERIMENTAL.............. 192 6.4.1 Selección de materiales............ 192 6.4.2 Obtención del porcentaje óptimo de asfalto........... 195 6.4.3 Caracterización mecánica y dinámica de las mezclas asfálticas............. 195 6.5 ANÁLISIS DE RESULTADOS.............. 203 6.6 CONCLUSIONES............... 204 Capítulo 7 EL EFECTO ARCO EN SUELOS John Mario García Giraldo 7.1 INTRODUCCIÓN............. 209 7.2 EL ARCO COMO FORMA ESTRUCTURAL.............. 210 7.2.1 Definición de arco.............. 210 7.2.2 Historia del arco como elemento estructural............. 211 7.3 F ORMAS DE ARCO............ 212 7.4 EFECTO DE LA GEOMETRÍA ESTRUCTURAL EN LA DISTRIBUCIÓN DE TENSIONES EN EL INTERIOR DE UN ELEMENTO............. 215 7.4.1 Esfuerzos en un elemento estructural............. 215 7.4.2 Distribución de tensiones en el interior de un elemento estructural............. 216 7.5 GEOMETRÍAS ÓPTIMAS............... 219 7.6 ESTUDIO DEL EFECTO ARCO EN LOS SUELOS............ 220 7.6.1 Efecto de arco sobre una escotilla móvil (trapdoor).............. 220 7.6.2 Análisis del efecto arco en los suelos por Terzaghi en 1945........... 222 7.7 ANÁLISIS DEL EFECTO ARCO EN LOS SUELOS POR HANDY EN 1985.............. 226 7.8 ANÁLISIS DEL EFECTO ARCO EN LOS SUELOS POR HARROP EN 1989.............. 233 7.9 ANÁLISIS DEL EFECTO ARCO EN LOS SUELOS POR SALGADO EN 2002.............. 237 7.10 CONCLUSIONES............ 241 Tercera parte Nuevos materiales compuestos o alternativos Capítulo 8 MATERIALES COMPUESTOS A BASE DE FERROCEMENTO Y MATERIAL VEGETA L Daniel Alveiro Bedoya Ruiz - Juan Camilo Aldana Barrera - Leonardo Ávila Vélez 8.1 INTRODUCCIÓN.............. 247 8.2 MATERIALES COMPUESTOS.............. 249 8.2.1 Núcleo............. 252 8.2.2 Corteza estructural............. 253 8.2.3 Sistemas constructivos............ 254 8.3 COMPORTAMIENTO EXPERIMENTAL DE LOS COMPUESTOS DE FERROCEMENTO Y MATERIAL VEGETAL............. 255 8.3.1 Núcleo de material vegetal............ 256 8.3.2 Corteza de ferrocemento.............. 260 8.3.3 A. 3.3 paneles de ferrocemento con núcleo vegetal............. 261 8.4 CONCLUSIONES.............. 266 Capítulo 9 COMPORTAMIENTO MECÁNICO DE SUELOS RESIDUALES ESTABILIZADO S César Augusto Hidalgo Montoya - Mario Alberto Rodríguez Moreno 9.1 INTRODUCCIÓN.............. 271 9.2 ESTABILIZACIÓN DE SUELOS CON CAL............. 273 9.3 PROPIEDADES RESILIENTES O RESILIENCIA............... 275 9.4 CARGAS EN EL PAVIMENTO.............. 276 9.4.1 Tipos de cargas que actúan............. 276 9.4.2 Duración de la carga cíclica............. 279 9.5 MÓDULO RESILIENTE............. 279 9.6 F ACTORES GENERALES QUE AFECTAN EL MÓDULO RESILIENTE............. 281 9.6.1 Factores que afectan el Mr de suelos finos............ 281 9.6.2 Factores que afectan el Mr de materiales granulares............ 284 9.7 ENSAYOS PARA DETERMINAR EL MÓDULO RESILIENTE.............. 286 9.8 CORRELACIONES............... 289 9.9 PROPIEDADES RESILIENTES DE SUELOS ESTABILIZADOS.............. 290 9.10 ENSAYOS DE LABORATORIO.............. 292 9.11 ANÁLISIS DE RESULTADOS............... 295 9.11.1 Compresión simple............ 296 9.11.2 Tracción indirecta............. 299 9.11.3 CBR............. 300 9.11.4 Módulo resiliente.............. 302 9.12 CONCLUSIONES.............. 30

Chikungunya Virus as Cause of Febrile Illness Outbreak, Chiapas, Mexico, 2014

Since chikungunya virus (CHIKV) was introduced into the Americas in 2013, its geographic distribution has rapidly expanded. Of 119 serum samples collected in 2014 from febrile patients in southern Mexico, 79% were positive for CHIKV or IgM against CHIKV. Sequencing results confirmed CHIKV strains closely related to Caribbean isolates

Identifying comorbidities and lifestyle factors contributing to the cognitive profile of early Parkinson's disease

Background: Identifying modifiable risk factors for cognitive impairment in the early stages of Parkinson's disease (PD) and estimating their impact on cognitive status may help prevent dementia (PDD) and the design of cognitive trials. Methods: Using a standard approach for the assessment of global cognition in PD and controlling for the effects of age, education and disease duration, we explored the associations between cognitive status, comorbidities, metabolic variables and lifestyle variables in 533 PD participants from the COPPADIS study. Results: Among the overall sample, 21% of participants were classified as PD-MCI (n = 114) and 4% as PDD (n = 26). The prevalence of hypertension, diabetes and dyslipidemia was significantly higher in cognitively impaired patients while no between-group differences were found for smoking, alcohol intake or use of supplementary vitamins. Better cognitive scores were significantly associated with regular physical exercise (p < 0.05) and cognitive stimulation (< 0.01). Cognitive performance was negatively associated with interleukin 2 (Il2) (p < 0.05), Il6 (p < 0.05), iron (p < 0.05), and homocysteine (p < 0.005) levels, and positively associated with vitamin B12 levels (p < 0.005). Conclusions: We extend previous findings regarding the positive and negative influence of various comorbidities and lifestyle factors on cognitive status in early PD patients, and reinforce the need to identify and treat potentially modifiable variables with the intention of exploring the possible improvement of the global cognitive status of patients with PD

Diplopia is frequent and associated with motor and non-motor severity in parkinson's disease : Results from the COPPADIS cohort at 2-year follow-up

Background and objective: Diplopia is relatively common in Parkinson's disease (PD) but is still understudied. Our aim was to analyze the frequency of diplopia in PD patients from a multicenter Spanish cohort, to compare the frequency with a control group, and to identify factors associated with it. Patients and Methods: PD patients who were recruited from January 2016 to November 2017 (baseline visit; V0) and evaluated again at a 2-year ± 30 days follow-up (V2) from 35 centers of Spain from the COPPADIS cohort were included in this longitudinal prospective study. The patients and controls were classified as "with diplopia" or "without diplopia" according to item 15 of the Non-Motor Symptoms Scale (NMSS) at V0, V1 (1-year ± 15 days), and V2 for the patients and at V0 and V2 for the controls. Results: The frequency of diplopia in the PD patients was 13.6% (94/691) at V0 (1.9% in controls [4/206]; p < 0.0001), 14.2% (86/604) at V1, and 17.1% (86/502) at V2 (0.8% in controls [1/124]; p < 0.0001), with a period prevalence of 24.9% (120/481). Visual hallucinations at any visit from V0 to V2 (OR = 2.264; 95%CI, 1.269-4.039; p = 0.006), a higher score on the NMSS at V0 (OR = 1.009; 95%CI, 1.012-1.024; p = 0.015), and a greater increase from V0 to V2 on the Unified Parkinson's Disease Rating Scale-III (OR = 1.039; 95%CI, 1.023-1.083; p < 0.0001) and Neuropsychiatric Inventory (OR = 1.028; 95%CI, 1.001-1.057; p = 0.049) scores were independent factors associated with diplopia (R = 0.25; Hosmer and Lemeshow test, p = 0.716). Conclusions: Diplopia represents a frequent symptom in PD patients and is associated with motor and non-motor severity

Escucha México, Estrategias gráficas y cultura auditiva. Primavera 2022

Durante Primavera 2022, el equipo de PAP Escucha México trabajó en diferentes proyectos con el objetivo de crear conciencia y sensibilizar sobre temáticas relacionadas a la cultura y discapacidad auditiva y el ruido excesivo en Guadalajara. A través de diferentes fuentes y medios de apoyo logramos transmitir la problemática a la comunidad, esto con el propósito de crecer el conocimiento que se tiene de la cultura auditiva. Los proyectos individuales que participan dentro del PAP son Cruzada Contra el Ruido, Clínica Mariana Anaya Doll, Iniciativa México Cubrebocas Transparente, Brankia, redes sociales del PAP Escucha México, Universidad Incluyente ITESO y la planeación del 4to Encuentro Internacional de Cultura Auditiva.Cada uno de estos se enfoca en temáticas diferentes sin embargo todos engloban las mencionadas al inicio.ITESO, A.C

Diplopia Is Frequent and Associated with Motor and Non-Motor Severity in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up

Malaltia de Parkinson; Fenotip; TremolorEnfermedad de Parkinson; Fenotipo; TemblorParkinson’s disease; Phenotype; TremorBackground and objective: Diplopia is relatively common in Parkinson’s disease (PD) but is still understudied. Our aim was to analyze the frequency of diplopia in PD patients from a multicenter Spanish cohort, to compare the frequency with a control group, and to identify factors associated with it. Patients and Methods: PD patients who were recruited from January 2016 to November 2017 (baseline visit; V0) and evaluated again at a 2-year ± 30 days follow-up (V2) from 35 centers of Spain from the COPPADIS cohort were included in this longitudinal prospective study. The patients and controls were classified as “with diplopia” or “without diplopia” according to item 15 of the Non-Motor Symptoms Scale (NMSS) at V0, V1 (1-year ± 15 days), and V2 for the patients and at V0 and V2 for the controls. Results: The frequency of diplopia in the PD patients was 13.6% (94/691) at V0 (1.9% in controls [4/206]; p < 0.0001), 14.2% (86/604) at V1, and 17.1% (86/502) at V2 (0.8% in controls [1/124]; p < 0.0001), with a period prevalence of 24.9% (120/481). Visual hallucinations at any visit from V0 to V2 (OR = 2.264; 95%CI, 1.269–4.039; p = 0.006), a higher score on the NMSS at V0 (OR = 1.009; 95%CI, 1.012–1.024; p = 0.015), and a greater increase from V0 to V2 on the Unified Parkinson’s Disease Rating Scale–III (OR = 1.039; 95%CI, 1.023–1.083; p < 0.0001) and Neuropsychiatric Inventory (OR = 1.028; 95%CI, 1.001–1.057; p = 0.049) scores were independent factors associated with diplopia (R2 = 0.25; Hosmer and Lemeshow test, p = 0.716). Conclusions: Diplopia represents a frequent symptom in PD patients and is associated with motor and non-motor severity.Solano Vila B. has received honoraria for educational presentations and advice service by UCB, Zambon, Teva, Abbvie, Bia

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe