From data acquisition to data fusion : a comprehensive review and a roadmap for the identification of activities of daily living using mobile devices

This paper focuses on the research on the state of the art for sensor fusion techniques, applied to the sensors embedded in mobile devices, as a means to help identify the mobile device user’s daily activities. Sensor data fusion techniques are used to consolidate the data collected from several sensors, increasing the reliability of the algorithms for the identification of the different activities. However, mobile devices have several constraints, e.g., low memory, low battery life and low processing power, and some data fusion techniques are not suited to this scenario. The main purpose of this paper is to present an overview of the state of the art to identify examples of sensor data fusion techniques that can be applied to the sensors available in mobile devices aiming to identify activities of daily living (ADLs)

AGREE-S: AGREE II extension for surgical interventions – United European Gastroenterology and European Association for Endoscopic Surgery methodological guide

Evidence; Guidelines; QualityEvidencia; Pautas; CalidadEvidència; Pautes; QualitatBackground The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument has been developed to inform the methodology, reporting and appraisal of clinical practice guidelines. Evidence suggests that the quality of surgical guidelines can be improved, and the structure and content of AGREE II can be modified to help enhance the quality of guidelines of surgical interventions. Objective To develop an extension of AGREE II specifically designed for guidelines of surgical interventions. Methods In the tripartite Guideline Assessment Project (GAP) funded by United European Gastroenterology and the European Association for Endoscopic Surgery, (i) we assessed the quality of surgical guidelines and we identified factors associated with higher quality (GAP I); (ii) we applied correlation analysis, factor analysis and the item response theory to inform an adaption of AGREE II for the purposes of surgical guidelines (GAP II); and (iii) we developed an AGREE II extension for surgical interventions, informed by the results of GAP I, GAP II, and a Delphi process of stakeholders, including representation from interventional and surgical disciplines; the Guideline International Network (GIN); the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group; the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) initiative; and representation of surgical journal editors and patient/public. Results We developed AGREE-S, an AGREE II extension for surgical interventions, which comprises 24 items organized in 6 domains; Scope and purpose, Stakeholders, Evidence synthesis, Development of recommendations, Editorial independence, and Implementation and update. The panel of stakeholders proposed 3 additional items: development of a guideline protocol, consideration of practice variability and surgical/interventional expertise in different settings, and specification of infrastructures required to implement the recommendations. Three of the existing items were amended, 7 items were rearranged among the domains, and one item was removed. The domain Rigour of Development was divided into domains on Evidence Synthesis and Development of Recommendations. The new domain Development of Recommendations incorporates items from the original AGREE II domain Clarity of Presentation. Conclusion AGREE-S is an evidence-based and stakeholder-informed extension of the AGREE II instrument, that can be used as a guide for the development and adaption of guidelines on surgical interventions.The Guideline Assessment Project (GAP) III received financial support from the United European Gastroenterology (UEG) and the European Association for Endoscopic Surgery and Other Interventional Techniques (EAES), both non-profit organizations. The funders had no role in the design or development of this project

Fluids in the treatment of diabetic ketoacidosis in children:A systematic review

Aim: To determine the comparative effectiveness of fluid schemes for children with diabetic ketoacidosis (DKA). Methods: We conducted a systematic review with an attempt to conduct network meta-analysis (NMA). We searched MEDLINE, EMBASE, CENTRAL, Epistemonikos, Virtual Health Library, and gray literature from inception to July 31, 2022. We included randomized controlled trials (RCTs) in children with DKA evaluating any intravenous fluid schemes. We planned to conduct NMA to compare all fluid schemes if heterogeneity was deemed acceptable. Results: Twelve RCTs were included. Studies were heterogeneous in the population (patients and DKA episodes), interventions with different fluids (saline, Ringer's lactate (RL), and polyelectrolyte solution-PlasmaLyte®), tonicity, volume, and administration systems. We identified 47 outcomes that measured clinical manifestations and metabolic control, including single and composite outcomes and substantial heterogeneity preventing statistical combination. No evidence was found of differences in neurological deterioration (main outcome), but differences were found among interventions in some comparisons to normalize acid-base status (∼2 h less with low vs. high volume); time to receive subcutaneous insulin (∼1 h less with low vs. high fluid rate); length of stay (∼6 h less with RL vs. saline); and resolution of the DKA (∼3 h less with two-bag vs. one-bag scheme). However, available evidence is scarce and poor. Conclusions: There is not enough evidence to determine the best fluid therapy in terms of fluid type, tonicity, volume, or administration time for DKA treatment. There is an urgent need for more RCTs, and the development of a core outcome set on DKA in children.</p

Principios del manejo hospitalario en pacientes con politraumatismo en cara, en el área de urgencias del servicio de cirugía maxilofacial

When we talk about physical trauma, we refer to a type of injury or wound that directly affects the body at the somatic level. The physical trauma can be caused both by blows and by sharp wounds, that is to say, by external elements that do not penetrate in the organism as for external elements that yes do it, the initial assistance with facial polytraumatism must approach the patient from a scheme with a clear and sequential methodology, which allows an effective resuscitation and a diagnosis and treatment of all the present injuries on order of importance. In the following work it proposes to announce the processes and / or guidelines that must be born in mind to the moment to stabilize the patient with severe traumatism to level of face during the immediate attention in the area of hospitable urgencies by means of a bibliographical review, demonstrating the importance of the interdisciplinary managing for the clinical managing of this type of patients.La siringomielia es un trastorno que consiste en la formación de uno o varios quistes en la médula espinal, que generalmente inician en la región cervical y pueden extenderse hasta la región torácica o hacia el tronco encefálico. Su etiología es multifactorial, pudiendo ser secundaria a malformación de Arnold-Chiari, causas idiopáticas, y traumatismos. Las manifestaciones clínicas son variadas presentando un curso crónico-progresivo. Se presenta el caso de una mujer de 47 años de edad con diagnóstico de siringomielia cervicotorácica, cuya manifestación inicial fue inusual, aguda y progresiva, ameritando procedimiento quirúrgico con buenos resultados. Se discute sobre la presentación clínica atípica y las medidas terapéuticas quirúrgicas empleadas en éste caso. (DUAZARY 2012 No. 2, 167 - 175

Dexamethasone versus betamethasone for preterm birth: a systematic review and network meta-analysis

Objective: This study aimed to evaluate the comparative clinical effectiveness and safety of dexamethasone vs betamethasone for preterm birth. Data Sources: The sources searched were MEDLINE, EMBASE, Cochrane Library, LILACS, ClinicalTrials.gov, and International Clinical Trials Registry Platform without language restrictions until October 2019 in addition to the reference lists of included studies. Field experts were also contacted. Study Eligibility Criteria: Randomized or quasi-randomized controlled trials comparing any corticosteroids against each other or against placebo at any dose for preterm birth were included in the study. Methods: Three researchers independently selected and extracted data and assessed the risk of bias of the included studies by using Early Review Organizing Software and Covidence software. Random-effects pairwise meta-analysis and Bayesian network meta-analysis were performed. The primary outcomes were chorioamnionitis, endometritis or puerperal sepsis, neonatal death, respiratory distress syndrome, and neurodevelopmental disability. Results: A total of 45 trials (11,227 women and 11,878 infants) were included in the study. No clinical or statistical difference was found between dexamethasone and betamethasone in neonatal death (odds ratio, 1.05; 95% confidence interval, 0.62–1.84; moderate-certainty evidence), neurodevelopmental disability (odds ratio, 1.03; 95% confidence interval, 0.80–1.33; moderate-certainty evidence), intraventricular hemorrhage (odds ratio, 1.04; 95% confidence interval, 0.56–1.78); low-certainty evidence), or birthweight (+5.29 g; 95% confidence interval, −49.79 to 58.97; high-certainty evidence). There was no statistically significant difference, but a potentially clinically important effect was found between dexamethasone and betamethasone in chorioamnionitis (odds ratio, 0.70; 95% confidence interval, 0.45–1.06; moderate-certainty evidence), fetal death (odds ratio, 0.81; 95% confidence interval, 0.24–2.41; low-certainty evidence), puerperal sepsis (odds ratio, 2.04; 95% confidence interval, 0.72–6.06; low-certainty evidence), and respiratory distress syndrome (odds ratio, 1.34; 95% confidence interval, 0.96–2.11; moderate-certainty evidence). Meta-regression, subgroup, and sensitivity analyses did not reveal important changes regarding the main analysis. Conclusion: Corticosteroids have proven effective for most neonatal and child-relevant outcomes compared with placebo or no treatment for women at risk of preterm birth. No important difference was found on neonatal death, neurodevelopmental disability, intraventricular hemorrhage, and birthweight between corticosteroids, and there was no statistically significant difference, but a potentially important difference was found in chorioamnionitis, fetal death, endometritis or puerperal sepsis, and respiratory distress syndrome. Further research is warranted to improve the certainty of evidence and inform health policies.Fil: Ciapponi, Agustín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Klein, Karen. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Colaci, Daniela. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Organizacion Mundial de la Salud; ArgentinaFil: Belizan, Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Deegan, Allie. University of New York; Estados UnidosFil: Veroniki, Areti Angeliki. University of Ioannina; Grecia. St. Michael’s Hospital. Li Ka Shing Knowledge Institute; CanadáFil: Florez, Ivan D.. Universidad de Antioquia; Colombia. Mc Master University; Canad

A framework for explaining the role of values in health policy decision-making in Latin America : a critical interpretive synthesis

Abstract: Background: Although values underpin the goals pursued in health systems, including how health systems benefit the population, it is often not clear how values are incorporated into policy decision-making about health systems. The challenge is to encompass social/citizen values, health system goals, and financial realities and to incorporate them into the policy-making process. This is a challenge for all health systems and of particular importance for Latin American (LA) countries. Our objective was to understand how and under what conditions societal values inform decisions about health system financing in LA countries. Methods: A critical interpretive synthesis approach was utilised for this work. We searched 17 databases in December 2016 to identify articles written in English, Spanish or Portuguese that focus on values that inform the policy process for health system financing in LA countries at the macro and meso levels. Two reviewers independently screened records and assessed them for inclusion. One researcher conceptually mapped the included articles, created structured summaries of key findings from each, and selected a purposive sample of articles to thematically synthesise the results across the domains of agenda-setting/prioritisation, policy development and implementation. Results: We identified 5925 references, included 199 papers, and synthesised 68 papers. We identified 116 values and developed a framework to explain how values have been used to inform policy decisions about financing in LA countries. This framework has four categories – (1) goal-related values (i.e. guiding principles of the health system); (2) technical values (those incorporated into the instruments adopted by policy-makers to ensure a sustainable and efficient health system); (3) governance values (those applied in the policy process to ensure a transparent and accountable process of decision-making); and (4) situational values (a broad category of values that represent competing strategies to make decisions in the health systems, their influence varying according to the four factors)..

AGREE-S : AGREE II extension for surgical interventions - United European Gastroenterology and European Association for Endoscopic Surgery methodological guide

The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument has been developed to inform the methodology, reporting and appraisal of clinical practice guidelines. Evidence suggests that the quality of surgical guidelines can be improved, and the structure and content of AGREE II can be modified to help enhance the quality of guidelines of surgical interventions. To develop an extension of AGREE II specifically designed for guidelines of surgical interventions. In the tripartite Guideline Assessment Project (GAP) funded by United European Gastroenterology and the European Association for Endoscopic Surgery, (i) we assessed the quality of surgical guidelines and we identified factors associated with higher quality (GAP I); (ii) we applied correlation analysis, factor analysis and the item response theory to inform an adaption of AGREE II for the purposes of surgical guidelines (GAP II); and (iii) we developed an AGREE II extension for surgical interventions, informed by the results of GAP I, GAP II, and a Delphi process of stakeholders, including representation from interventional and surgical disciplines; the Guideline International Network (GIN); the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group; the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) initiative; and representation of surgical journal editors and patient/public. We developed AGREE-S, an AGREE II extension for surgical interventions, which comprises 24 items organized in 6 domains; Scope and purpose, Stakeholders, Evidence synthesis, Development of recommendations, Editorial independence, and Implementation and update. The panel of stakeholders proposed 3 additional items: development of a guideline protocol, consideration of practice variability and surgical/interventional expertise in different settings, and specification of infrastructures required to implement the recommendations. Three of the existing items were amended, 7 items were rearranged among the domains, and one item was removed. The domain Rigour of Development was divided into domains on Evidence Synthesis and Development of Recommendations. The new domain Development of Recommendations incorporates items from the original AGREE II domain Clarity of Presentation. AGREE-S is an evidence-based and stakeholder-informed extension of the AGREE II instrument, that can be used as a guide for the development and adaption of guidelines on surgical interventions

Análisis diseño e implementación de aplicación Móvil apprecycling

Enlace GitHub, enlace formulario aplicación de pruebas, enlace APK, enlace Video tutorial Manual de UsuarioLa siguiente monografía evidencia el proceso de creación de una aplicación, iniciando por una problemática hasta la creación, análisis, desarrollo y evaluación, la aplicación se realizó con la plataforma Android Studio. El proceso muestra al público en general que usando diferentes medios tecnológicos como también plataformas se puede crear un sin fin de oportunidades para ayudarnos como sociedad y aportar al cuidado del medio ambiente, demostrando que el trabajo en equipo es muy importante al realizarlo bajo un mismo objetivo para alcanzar las metas propuestas. Una vez realizada la aplicación se pudo concluir que a través del uso de la tecnología y por medio de Android Studio es posible y viable desarrollar un software en lenguaje JAVA para enseñar sobre el reciclaje a los habitantes de la ciudad de Bogotá. El software realizado puede Incentivar a los usuarios para la correcta clasificación de los desechos, al mismo tiempo que capacita sobre la importancia y aporte al medio ambiente con la práctica del reciclaje. La aplicación permite brindar información tan valiosa como los puntos de reciclaje a partir de los productos que se desee desechar. Se pudo encontrar una gran cantidad de material e información para el desarrollo de la aplicación Móvil, sin embargo, fue importante tener como base nociones básicas de desarrollo en Java. Se espera que el documento sea base para posteriores trabajos y generé cimientos de conocimiento.The following monograph shows the process of developing an app, starting with a problem until the creation, analysis and evaluation, the application was made with the Android Studio platform. The process shows to people that using different tech devices as well as platforms, endless opportunities can be created to help us as a society and contribute to help the environment, demonstrating that work as a team is very important when we working it under the same objective to achieve the goals. Once the application was made, we could concluded that through the use of technology and through Android Studio it is possible and feasible to develop a software in JAVA language to teach population of the city of Bogotá about recycling. The software made can motivate users for the correct classification of waste, at the same time as training on the importance and contribution to the environment with the practice of recycling. The application allows you to provide information as valuable as the recycling points from the products you want to dispose of. A large amount of material and information could be found for the development of the Mobile application, however, it was important to have as a base basic notions of development in Java. It is expected that the document will be the basis for further work and generated a foundation of knowledge

Assessment of the quality of recommendations from 161 clinical practice guidelines using the Appraisal of Guidelines for Research and Evaluation-Recommendations Excellence (AGREE-REX) instrument shows there is room for improvement

To assess the quality of recommendations from 161 clinical practice guidelines (CPGs) using AGREE-REX-D (Appraisal of Guidelines REsearch and Evaluation-Recommendations Excellence Draft). International CPG community. Three hundred twenty-two international CPG developers, users, and researchers. Participants were assigned to appraise one of 161 CPGs selected for the study using the AGREE-REX-D tool Main outcome measures: AGREE-REX-D scores of 161 CPGs (7-point scale, maximum 7). Recommendations from 161 CPGs were appraised by 322 participants using the AGREE-REX-D. CPGs were developed by 67 different organizations. The total overall average score of the CPG recommendations was 4.23 (standard deviation (SD) = 1.14). AGREE-REX-D items that scored the highest were (mean; SD): evidence (5.51; 1.14), clinical relevance (5.95; SD 0.8), and patients/population relevance (4.87; SD 1.33), while the lowest scores were observed for the policy values (3.44; SD 1.53), local applicability (3,56; SD 1.47), and resources, tools, and capacity (3.49; SD 1.44) items. CPGs developed by government-supported organizations and developed in the UK and Canada had significantly higher recommendation quality scores with the AGREE-REX-D tool (p < 0.05) than their comparators. We found that there is significant room for improvement of some CPGs such as the considerations of patient/population values, policy values, local applicability and resources, tools, and capacity. These findings may be considered a baseline upon which to measure future improvements in the quality of CPGs

Estudio del clima organizacional de la Universidad Nacional Abierta y a Distancia UNAD, CEAD Palmira: principales factores que impactan a los empleados durante el año 2022

El presente trabajo es el resultado de una construcción colaborativa que pretende de forma descriptiva analizar los factores que influyen en los trabajadores en relación con el clima organizacional de la Universidad Nacional Abierta y a Distancia UNAD sede Palmira, durante el año 2022 con el fin de ejecutar estrategias de intervención. Se considera una etapa exploratoria, debido a que las evidencias de trabajos investigativos sobre el clima organizacional de la institución son escasas, con lo que se espera a fututo esta trabajo sea complemento de futuras investigaciones o refutaciones sobre los hallazgos encontrados, en la actualidad la UNAD siendo una de las principales y primeras instituciones que permiten de forma 100% virtual el desarrollo pregrados y posgrados, en este abanico de posibilidades de estudio se desarrollan diversos factores internos de la institución que generan diversos grados de estrés e inconformidades que no permiten catalogar a la institución como uno de los mejores lugares para trabajar. Esta investigación está sustentada en algunos antecedentes que con relación al tema de clima organizacional se han realizado en el pasado dentro del contexto colombiano y un trabajo de campo realizado a integrantes directos e indirectos de la institución, permitiéndonos sustraer material de investigación, con el fin de reconocer estrategias, discusiones y metodologías de trabajo que sean útiles para este proyecto y nos permitan proponer hipótesis y conclusiones Palabras claves: Clima laboral, análisis descriptivo, antecedentes, grado de estrés, impactos negativos.The present work is the result of a collaborative construction that intends to descriptively analyze the factors that influence workers in relation to the organizational climate of the National Open and Distance University UNAD Palmira, during the year 2022 in order to execute strategies of intervention. It is considered an exploratory stage, due to the fact that the evidence of investigative work on the organizational climate of the institution is scarce, with which it is expected that in the future this work will be a complement to future investigations or refutations of the findings found, currently the UNAD being one of the main and first institutions that allow 100% virtual undergraduate and postgraduate development, in this range of study possibilities, various internal factors of the institution are developed that generate different degrees of stress and disagreements that do not allow to classify the institution as one of the best places to work. This research is based on some background information that has been carried out in the past in the Colombian context in relation to the topic of organizational climate, and field work carried out with direct and indirect members of the institution, allowing us to subtract research material, in order to recognize strategies, discussions and work methodologies that are useful for this project and allow us to propose hypotheses and conclusions Keywords: Work environment, descriptive analysis, background, degree of stress, negative impacts.