Diagnosis of Subclinical Keratoconus with a Combined Model of Biomechanical and Topographic Parameters

This study sought to develop a diagnostic model with aberrometry and biomechanical variables for subclinical keratoconus. The design was a cross-sectional study. The topographic data were obtained with a rotating Scheimpflug camera (Pentacam HR), and biomechanical data were obtained with Corvis ST. The study included 81 eyes distributed in 61 healthy corneas and 20 subclinical keratoconus (SCKC), defined as eyes with suspicious topographic findings, normal slit-lamp examination, and a manifestation of keratoconus. Analyses of the topographic and biomechanical data were performed, and a classifying model of SCKC was elaborated. The model for the diagnosis of SCKC includes posterior coma to 90°, Ambrósio’s Relational Thickness in the horizontal profile (ARTh), and velocity when the air pulse is off (A2 velocity). The sensitivity was 89.5%, specificity 96.7%, accuracy 94.9%, and precision 89.5%. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for the model was 0.951. Diagnosis of subclinical keratoconus depends on the aberrometry variable posterior coma to 90° and the biomechanical variables A2 velocity and ARTh

O6-methylguanine-DNA Methyltransferase Promoter Methylation in Patients with Rectal Adenocarcinoma After Chemoradiotherapy Treatment: Clinical Implications

Brief Report 283Aims: To analyze the clinical relevance of O6-methylguanine-DNA methyltransferase in rectal adenocarcinoma treated with chemoradiotherapy followed by surgery. Methods: Tissue samples from 29 rectal adenocarcinoma patients were obtained after chemoradiotherapy. O6-methylguanine-DNA methyltransferase promoter methylation status was established by methylation-specific polymerase chain reaction. O6-methylguanine-DNA methyltransferase protein levels were determined by immunohistochemistry. Clinicopathologic variables, including treatment regression grade, recurrence, lymph node invasion, and stage and differentiation grade of the tumor, were determined. Results: The O6-methylguanine-DNA methyltransferase gene promoter was methylated in 81.5% of samples. Most patients (88.9%) showed low O6-methylguanine-DNA methyltransferase protein expression. O6-methylguanine-DNA methyltransferase methylation status was not correlated with any of the clinicopathological variables determined in rectal adenocarcinomas selected for chemoradiotherapy. Conclusion: O6-methylguanine-DNA methyltransferase methylation status is not correlated with clinicopathologic variables examined in rectal adenocarcinoma selected for chemoradiotherapy, although its role as a biomarker awaits further investigation

El marketing digital como estrategia en las MIPyMES turísticas de Tenosique, Tabasco

El marketing digital en las MIPyMES posibilita el crecimiento del negocio estableciendo una mejor comunicación con sus clientes. En Tenosique, Tabasco, los propietarios y gerentes de las MIPyMES turísticas utilizan métodos de marketing tradicionales. Esta investigación tuvo como objetivo determinar el nivel de conocimiento del marketing digital identificando las herramientas utilizadas en las MIPyMES turísticas de Tenosique, Tabasco. Se aplicó un cuestionario a gerentes de empresas turísticas. Los resultados indican que las herramientas de marketing digital más utilizadas son redes sociales, email marketing y motores de búsqueda. Los entrevistados perciben que el marketing digital en sus empresas les generaría costos adicionales que no están a su alcance. Asimismo, para la implementación de estrategias de marketing digital se requiere mayor inversión en infraestructura tecnológica que la disponible en estas empresas. También presentan carencias en cuanto a la capacitación del recurso humano requerido para implementar estas herramientas

Eficiencia de uniformidad del riego por exudación en producción de Ca-psicum chinense Jacq. y su repercusión económica

In the search for agricultural irrigation systems that increase efficiency in the use of water, it was necessary to evaluate the uniformity and profitability of the irrigation system by exudation in the production of habanero pepper (Capsicum chinense Jacq.). A randomized complete block analysis of variance was performed, with two treatments (exudation and dripping) with four repetitions. Irrigation by exudation showed greater application efficiency with a sheet of usable moisture (LHA) of 0.395 cm per day, while the drip system showed a LHA of 0.470 cm. Irrigation by exudation in the same way presented a higher coefficient of flow uniformity with 93% while by dripping it showed 89%, when evaluating the coefficient of pressure uniformity, this was higher in irrigation by exudation with 98% while that by drip was 89%. In the economic aspect, the irrigation by exudation generated a profitability of 77.91% and by drip 68.68% with a higher benefit/cost ratio of irrigation by exudation (3.53) than drip irrigation (2.19). From the results it is concluded that exudation irrigation is a viable alternative for its use in the cultivation of habanero pepper.En la búsqueda de sistemas de riego agrícola que incrementen la eficiencia en el uso del agua, fue necesario evaluar la uniformidad y rentabilidad del sistema de riego por exudación en la producción de chile habanero (Capsicum chinense Jacq.). Se realizó un análisis de varianza de bloques completos al azar, con dos tratamentos (exudación y goteo) con cuatro repeticiones. El riego por exudación presentó mayor eficiencia de aplicación con una lámina de humedad aprovechable (LHA) de 0,395 cm diarios, mientras que el sistema por goteo mostró una LHA de 0,470 cm. El riego por exudación de igual manera presentó mayor coeficiente de uniformidad de caudal con 93% mientras que por goteo mostró un 89%, al evaluar el coeficiente de uniformidad de presión, esté fue superior en el riego por exudación con un 98% mientras que por goteo fue de un 89%. En el aspecto económico el riego por exudación generó una rentabilidad del 77,91% y por goteo el 68,68% con una mayor relación beneficio/costo el riego por exudación (3,53) que el riego por goteo (2,19). A partir de los resultados se concluye que el riego por exudación es una alternativa viable para su uso en el cultivo de chile habanero

Lienzo para construir el perfil de un consumidor para un emprendimiento sostenible

2021 puede ser un año que fortalecerá el emprendimiento social. Con los sucesos actuales, la tendencia mundial es hacia ver la salud como un nuevo lujo, encontrar modelos de negocio con impacto, hacer más con menos, pero sin comprometer al medio ambiente actual y futuro; y ser consumidores conscientes adquiriendo con responsabilidad (The Economist, 2020; Euromonitor International, 2019). Perfilar al cliente ideal para un nuevo producto, servicio o emprendimiento es un proceso que contiene elementos fundamentales para conocerle y formas estratégicas alrededor del mismo. Una herramienta útil para ello es el buyer persona (Zambito, 2010), sin embargo, en un estudio previo se observó que de diez lienzos analizados, ninguno cubre las necesidades de información para entender a un cliente responsable y consciente, el cual es el target de los emprendimientos sociales principalmente. Se propone un lienzo de buyer persona construido a partir de una investigación cualitativa y bibliográfica, haciendo entrevistas a emprendedores iniciales buscando resolver un problema social, así como prototipado y pivoteo del lienzo. Con ello se propone un canvas de buyer persona para definir el perfil de un cliente de productos, o proyectos con impacto social. Este material puede servir en el aula como apoyo para la educación en emprendimiento, mientras que, para el desarrollo de emprendimiento social, podría servir como herramienta adicional

Propuesta de integración curricular de la Aplicación Educativa GEONICA como recurso de Apoyo en la Asignatura de Estudios Sociales de Séptimo Grado de Educación Media de Nicaragua, en la unidad No. I: Espacio Territorial de Nicaragua; Posición geográfica y astronómica de Nicaragua

Con la llegada de la tecnología en la sociedad y el gran auge que ha venido teniendo las mismas en diferentes medios que han ido adaptando en todos los ámbitos, incluso en el educativo. Por lo tanto, el uso de la tecnología de la información y la comunicación (TIC) en las aulas cada vez es más habitual, lo que está transformando las aulas, cambiando los roles en la relación profesor-alumno, actualizando la forma de impartir clases y necesitando de la formación y actualización de los docentes; cada día se plantean nuevos retos para el uso de TIC en el aula de clase, ya que esta incorporación permite una mejora significativa en la calidad del proceso de enseñanza aprendizaje. La aplicación “GeoNica” es de tipo ejercitadora y practica lo que le permitirá al estudiante desarrollar habilidades que contribuyan al proceso de aprendizaje, además que ayudará a que el proceso sea más dinámico, interactivo y así lograr llamar la atención de los estudiantes y a la vez desarrollarán nuevas experiencias, además de promover la atención e interés en la asignatura y los contenidos en estudio a evaluar. La creación de la aplicación educativa realizada en el sistema de autor App Inventor2 se basada en un entorno de desarrollo visual de aplicaciones para dispositivos Android. Está aplicación se validó la a través de una encuesta aplicada a los estudiantes de séptimo grado de Educación Media, en el Colegio Público Miguel de Cervante

The coming age of flavonoids in the treatment of diabetic complications

Diabetes mellitus (DM), and its micro and macrovascular complications, is one of the biggest challenges for world public health. Despite overall improvement in prevention, diagnosis and treatment, its incidence is expected to continue increasing over the next years. Nowadays, finding therapies to prevent or retard the progression of diabetic complications remains an unmet need due to the complexity of mechanisms involved, which include inflammation, oxidative stress and angiogenesis, among others. Flavonoids are natural antioxidant compounds that have been shown to possess anti-diabetic properties. Moreover, increasing scientific evidence has demonstrated their potential anti-inflammatory and anti-oxidant effects. Consequently, the use of these compounds as anti-diabetic drugs has generated growing interest, as is reflected in the numerous in vitro and in vivo studies related to this field. Therefore, the aim of this review is to assess the recent pre-clinical and clinical research about the potential effect of flavonoids in the amelioration of diabetic complications. In brief, we provide updated information concerning the discrepancy between the numerous experimental studies supporting the eficacy of flavonoids on diabetic complications and the lack of appropriate and well-designed clinical trials. Due to the well-described beneficial effects on different mechanisms involved in diabetic complications, the excellent tolerability and low cost, future randomized controlled studies with compounds that have adequate bioavailability should be evaluated as add-on therapy on well-established anti-diabetic drugsThis paper was not funded. The authors work has been supported by FEDER-ISCIII Funds (PI17/00130, PI17/01495), Spanish Ministry of Economy and Competitiveness (RTI2018-098788-B-100, DTS17/00203, DTS19/00093, RYC-2017-22369), Spanish Society of Cardiology (SEC), Spanish Society of Nephrology (SEN) and Spanish Society of Atherosclerosis (SEA). TCO is an employee of FAES Pharma. The authors (except JAM) have an ongoing research project in common with FAES Pharma on Flavonoids in diabetic complications under the auspices of the joint-RETOS Collaborations Project 2017 (RTC-2017-6089-1), program supported by Spanish Ministry of Economy and Competitiveness

Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery

1) Background: Refractive surgery is an increasingly popular procedure for decreasing spectacle or contact lens dependency. The two most common surgical techniques to correct myopia are photorefractive keratectomy (PRK) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK). This study demonstrates the long-term effectiveness, safety, and predictability of both techniques for the refractive surgery of myopia. (2) Methods: A retrospective non-randomized study was performed. We followed 509 PRK eyes and 310 FS-LASIK surgeries for ten years. Patients were followed-up after 3 months and after 1, 2, 5, and 10 years, gathering data on their uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA). The safety index of both procedures was defined as the quotient between the postoperative BCVA and the preoperative BCVA. We defined a procedure as safe if this quotient was equal to or greater than 1. The effectiveness index was calculated as the quotient between postoperative UCVA divided by the preoperative BCVA. (3) Results: The safety index was higher than 1 (1.09) and an effectiveness index of 0.82 after ten years of surgery in both groups was found. (4) Conclusion: These data demonstrated excellent safety and effectiveness indices for both techniques, although FS-LASIK is a technique with better safety and effectiveness indices than PRK

Users’ perception of violence and conflicts with professionals in primary care centers before and during covid-19. a qualitative study

Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users’ point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide

Drivers of the Ectoparasite Community and Co-Infection Patterns in Rural and Urban Burrowing Owls

We analyzed the ectoparasite community of a monomorphic and non-social bird, the burrowing owl, Athene cunicularia, breeding in rural and urban habitats. Such community was composed by two lice, one mite and one flea species. Rural individuals had more fleas and less mites than urban ones. Adult birds harbored less ectoparasites than young ones and females harbored more lice than males. The presence of lice was positively related to the presence of fleas. On the contrary, the presence of mites was negatively related to the presence of fleas and lice. The study of parasite communities in urban and rural populations of the same species can shed light on how urban stressor factors impact the physiology of wildlife inhabiting cities and, therefore, the host-parasite relationships. Urbanization creates new ecological conditions that can affect biodiversity at all levels, including the diversity and prevalence of parasites of species that may occupy these environments. However, few studies have compared bird-ectoparasite interactions between urban and rural individuals. Here, we analyze the ectoparasite community and co-infection patterns of urban and rural burrowing owls, Athene cunicularia, to assess the influence of host traits (i.e., sex, age, and weight), and environmental factors (i.e., number of conspecifics per nest, habitat type and aridity) on its composition. Ectoparasites of burrowing owls included two lice, one flea, and one mite. The overall prevalence for mites, lice and fleas was 1.75%, 8.76% and 3.50%, respectively. A clear pattern of co-infection was detected between mites and fleas and, to less extent, between mites and lice. Adult owls harbored fewer ectoparasites than nestlings, and adult females harbored more lice than males. Our results also show that mite and flea numbers were higher when more conspecifics cohabited the same burrow, while lice showed the opposite pattern. Rural individuals showed higher flea parasitism and lower mite parasitism than urban birds. Moreover, mite numbers were negatively correlated with aridity and host weight. Although the ectoparasitic load of burrowing owls appears to be influenced by individual age, sex, number of conspecifics per nest, and habitat characteristics, the pattern of co-infection found among ectoparasites could also be mediated by unexplored factors such as host immune response, which deserves further research