Singularizar procesos: una propuesta de continuidad entre la actividad clínica y los objetivos de salud de las políticas sanitarias

ResumenAntecedentes y objetivosLa Dirección Territorial de Sanidad de Gipuzkoa creó en 1996 el servicio del Plan de Salud con la finalidad de transformar los objetivos de salud priorizados por el Departamento de Sanidad en estrategias de intervención a incorporar a los contratos programa.Proceso y resultadosel procedimiento que el servicio está utilizando para cumplir este objetivo se denomina singularización y consiste en seleccionar un proceso vinculado a un problema de salud prioritario, analizarlo y reconstruirlo de forma que se conozca la actividad relacionada con él, los resultados, el coste económico y su impacto en la salud de la población. El procedimiento permite a la Dirección Territorial de Sanidad, responsable de la compra de servicios al sector público y privado, disponer de información sobre las condiciones de contratación para el proceso revisado. La evaluación anual de los Contratos programa y Conciertos controla el grado de consecución de los pactos realizados y de sus consecuencias sobre la salud de la población. El artículo que se presenta recoge la forma en la que se realiza esta singularización.AbstractBackgrounds and objectivesIn 1996 the Gipuzkoa Territorial Health Agency (Basque Country, Spain) created the Health Plan Service. The aim was to transform the health objectives prioritized by the Health Department into intervention strategies to be incorporated into the local contract services.Process and resultsOne of the procedures the service uses for this purpose, known as «singularization», involves selecting a process linked to a prioritized health problem, and analyzing and reconstructing it so that the related activity, expected results, financial costs and its impact on the population's health can be identified. After this process the service provides the Territorial Health Agency, which is responsible for service purchase for the public and private sectors, with information about contract conditions for the process reviewed. Annual assessment of contract services monitors the extent to which the agreements made have been carried out and their consequences on the population's health. The present article deals with the process through which this «singularization» is carried out

Reflexiones sobre psicoprofilaxis quirúrgica en niños cardiópatas (II) Cuestionamiento de la psicoprofilaxis como simple información.

Describe las ansiedades de una niña de cinco años, a la hora de enfrentarse a la operación de corazón a la que iba a ser sometida y las dificultades para asumir la información acerca de lo que le iba a suceder. Se comentan los mecanismos de defensa que más utiliza, y su evolución psicológica hasta dos años después de la operación. Los autores son partidarios de una metodología individualizada, adaptada al funcionamiento mental del niño, en la práctica de la psicoprofilaxis quirúrgica

A logical approach to A-Prolog

It has been recently provided a characterization of Answer Sets by intuitionistic logic as follows: a literal is entailed by a program in the stable model semantics if and only if it belongs to every intuitionistically complete and consistent extension of the program formed by adding only negated literals. We show that if we replace intuitionistic logic by any si-logic the result still holds

Reflexiones sobre psicoprofilaxis quirúrgica en niños cardiópatas (II) Cuestionamiento de la psicoprofilaxis como simple información.

Describe las ansiedades de una niña de cinco años, a la hora de enfrentarse a la operación de corazón a la que iba a ser sometida y las dificultades para asumir la información acerca de lo que le iba a suceder. Se comentan los mecanismos de defensa que más utiliza, y su evolución psicológica hasta dos años después de la operación. Los autores son partidarios de una metodología individualizada, adaptada al funcionamiento mental del niño, en la práctica de la psicoprofilaxis quirúrgica

Oxysterols: A world to explore

Oxysterols (oxidized derivatives of cholesterol and phytosterols) can be generated in the human organism through different oxidation processes, some requiring enzymes. Furthermore, oxysterols are also present in food due to lipid oxidation reactions caused by heating treatments, contact with oxygen, exposure to sunlight, etc., and they could be absorbed from the diet, at different rates depending on their side chain length. In the organism, oxysterols can follow different routes: secreted into the intestinal lumen, esterified and distributed by lipoproteins to different tissues or degraded, mainly in the liver. Cholesterol oxidation products (COPs) have shown cytotoxicity, apoptotic and pro-inflammatory effects and they have also been linked with chronic diseases including atherosclerotic and neurodegenerative processess. In the case of phytosterol oxidation products (POPs), more research is needed on toxic effects. Nevertheless, current knowledge suggests they may also cause cytotoxic and pro-apoptotic effects, although at higher concentrations than COPs. Recently, new beneficial biological activities of oxysterols are being investigated. Whereas COPs are associated with cholesterol homeostasis mediated by different mechanisms, the implication of POPs is not clear yet. Available literature on sources of oxysterols in the organism, metabolism, toxicity and potential beneficial effects of these compounds are reviewed in this paper

PennyLane: Automatic differentiation of hybrid quantum-classical computations

PennyLane is a Python 3 software framework for optimization and machine learning of quantum and hybrid quantum-classical computations. The library provides a unified architecture for near-term quantum computing devices, supporting both qubit and continuous-variable paradigms. PennyLane's core feature is the ability to compute gradients of variational quantum circuits in a way that is compatible with classical techniques such as backpropagation. PennyLane thus extends the automatic differentiation algorithms common in optimization and machine learning to include quantum and hybrid computations. A plugin system makes the framework compatible with any gate-based quantum simulator or hardware. We provide plugins for Strawberry Fields, Rigetti Forest, Qiskit, Cirq, and ProjectQ, allowing PennyLane optimizations to be run on publicly accessible quantum devices provided by Rigetti and IBM Q. On the classical front, PennyLane interfaces with accelerated machine learning libraries such as TensorFlow, PyTorch, and autograd. PennyLane can be used for the optimization of variational quantum eigensolvers, quantum approximate optimization, quantum machine learning models, and many other applications.Comment: Code available at https://github.com/XanaduAI/pennylane/ . Significant contributions to the code (new features, new plugins, etc.) will be recognized by the opportunity to be a co-author on this pape

The Tyrosine Phosphatase hPTPRβ Controls the Early Signals and Dopaminergic Cells Viability via the P2X7 Receptor

ATP, one of the signaling molecules most commonly secreted in the nervous system and capable of stimulating multiple pathways, binds to the ionotropic purinergic receptors, in particular, the P2X7 receptor (P2X7R) and stimulates neuronal cell death. Given this effect of purinergic receptors on the viability of dopaminergic neurons model cells and that Ras GTPases control Erk1/2-regulated mitogen-activated cell proliferation and survival, we have investigated the role of the small GTPases of the Ras superfamily, together with their regulatory and effector molecules as the potential molecular intermediates in the P2X7R-regulated cell death of SN4741 dopaminergic neurons model cells. Here, we demonstrate that the neuronal response to purinergic stimulation involves the Calmodulin/RasGRF1 activation of the small GTPase Ras and Erk1/2. We also demonstrate that tyrosine phosphatase PTPRβ and other tyrosine phosphatases regulate the small GTPase activation pathway and neuronal viability. Our work expands the knowledge on the intracellular responses of dopaminergic cells by identifying new participating molecules and signaling pathways. In this sense, the study of the molecular circuitry of these neurons is key to understanding the functional effects of ATP, as well as considering the importance of these cells in Parkinson’s Disease.This work were supported by: A.A.S. is a recipient of a predoctoral Basque Government fellowship: PRE_2017_1_0016; M.L.M. is a recipient of a fellowship from Foundation “Jesús de Gangoiti y Barrera”: Foundation “Jesús de Gangoiti y Barrera”; J.L.Z. was supported by the Instituto de Salud Carlos III: (PI18/00207); J.L.Z. was supported by the Basque Government: (PIBA_2020_1_0048); J.L.Z. was supported by the University of Basque Country Grant: (US19/04). A.A.S. is a recipient of a predoctoral fellowship (PRE_2017_1_0016) from the Basque Government; M.L.M. is a recipient of a fellowship from Foundation “Jesús de Gangoiti y Barrera”; J.L.Z. was supported by the Instituto de Salud Carlos III (PI18/00207), Basque Government (PIBA_2020_1_0048) and University of Basque Country Grant (US19/04)