Integració en una xarxa d'àrea local d'un sistema d'autentificació sense fils amb un servidor RADIUS

L'objectiu principal del projecte és l'autentificació i validació dels alumnes que assisteixen a l'institut amb el seu portàtil personal, en la xarxa de cadascuna de les aules a les qual pertanyen, sense necessitat de connectar-se amb un cable.El objetivo principal del proyecto es la autentificación y validación de los alumnos que asisten al instituto con su portátil personal, en la red de cada una de las aulas a las que pertenecen, sin necesidad de conectarse con un cable

Functional characterization of a GGPPS variant indentified in atypical femoral fracture patients and delineation of the role of GGPPS in bone-relevant cell types

Atypical femoral fractures (AFFs) are a rare but potentially devastating event, often but not always linked to bisphosphonate (BP) therapy. The pathogenic mechanisms underlying AFFs remain obscure, and there are no tests available that might assist in identifying those at high risk of AFF. We previously used exome sequencing to explore the genetic background of three sisters with AFFs and three additional unrelated AFF cases, all previously treated with BPs. We detected 37 rare mutations (in 34 genes) shared by the three sisters. Notably, we found a p.Asp188Tyr mutation in the enzyme geranylgeranyl pyrophosphate synthase, a component of the mevalonate pathway, which is critical to osteoclast function and is inhibited by N-BPs. In addition, the CYP1A1 gene, responsible for the hydroxylation of 17β-estradiol, estrone, and vitamin D, was also mutated in all three sisters and one unrelated patient. Here we present a detailed list of the variants found and report functional analyses of the GGPS1 p.Asp188Tyr mutation, which showed a severe reduction in enzyme activity together with oligomerization defects. Unlike BP treatment, this genetic mutation will affect all cells in the carriers. RNAi knockdown of GGPS1 in osteoblasts produced a strong mineralization reduction and a reduced expression of osteocalcin, osterix, and RANKL, whereas in osteoclasts, it led to a lower resorption activity. Taken together, the impact of the mutated GGPPS and the relevance of the downstream effects in bone cells make it a strong candidate for AFF susceptibility. We speculate that other genes such as CYP1A1 might be involved in AFF pathogenesis, which remains to be functionally proved. The identification of the genetic background for AFFs provides new insights for future development of novel risk assessment tools. © 2018 American Society for Bone and Mineral Research

GGPS1 Mutation and Atypical Femoral Fractures with Bisphosphonates

Atypical femoral fractures have been associated with long-term bisphosphonate treatment.1,2 However, the underlying mechanisms remain obscure. We studied three sisters who had atypical femoral fractures after receiving various oral bisphosphonates for 6 years. Two of the sisters had a single fracture (at the ages of 64 and 73 years), and one had bilateral fractures (one at the age of 60 years and the other at the age of 61 years). Given the low incidence of atypical femoral fractures in the general population (5.9 per 10,000 person-years),3 we hypothesized that these sisters might have an underlying genetic background that contributed to these fractures

Self-harm consultations during the first year of COVID-19 pandemic: Study in four Argentine provinces

INTRODUCCIÓN: Es objeto de debate si la conducta suicida se vio impactada por la pandemia por COVID-19 y las medidas de aislamiento asociadas. Una vía para caracterizar la conducta suicida son las consultas a los servicios de emergencia en salud por lesiones autoinfligidas. El objetivo fue describir y analizar las consultas por conducta suicida, comparando los períodos de pandemia y prepandemia. MÉTODOS: Se realizó un estudio descriptivo de corte transversal con análisis de fuentes secundarias en tres hospitales generales y tres neuropsiquiátricos de cuatro provincias argentinas. Se relevaron consultas de febrero, julio y octubre del período de estudio. Se midieron variables sociodemográficas y referidas al episodio autolesivo. Se utilizaron frecuencias relativas y tasas para el análisis. RESULTADOS: Se analizaron 411 casos de consulta por lesión autoinfligida. El 73% fue del período previo a 2020. Al comparar los períodos prepandemia y pandemia, se observó un aumento en la tasa de consultas en el segundo, particularmente significativo en los hospitales neuropsiquiátricos. La derivación a otro establecimiento fue mayor en el período de pandemia. El envenenamiento fue el mecanismo de ocurrencia más habitual en ambos períodos, pero disminuyó durante la pandemia, cuando creció el uso de objetos cortantes. DISCUSIÓN: Se requiere continuar con el monitoreo de las consultas por lesiones autoinfligidas y abordar las diferencias de demanda entre hospitales generales y especializados.INTRODUCTION: The impact of COVID-19 pandemic and associated lockdowns on suicide behavior has been a matter of debate. Self-harm consultations to emergency departments are a way to analyze suicidal behavior. The objective was to describe and analyze self-harm consultations, comparing the pandemic and pre-pandemic periods. METHODS: A cross-sectional descriptive study was conducted with secondary source analysis in three general hospitals and three neuropsychiatric hospitals from four Argentine provinces. Consultations reported in February, July and October over the analyzed period were considered for the study. Data gathered included sociodemographic variables and those related to the self-harm event. Relative frequencies and rates were used for the analysis. RESULTS: A total of 411 self-harm consultations were included in the analysis, 73% of them were from the pre-pandemic period. Consultation rates were higher in the pandemic period, with a particularly significant increase in neuropsychiatric hospitals. Referral to another facility was higher during the pandemic. Poisoning was the most frequently used mechanism in both periods, even though it diminished during the pandemic period, when the use of sharp objects increased. DISCUSSION: It is necessary to continue monitoring self-harm consultations, and the differences between demand to general and specialized neuropsychiatric hospitals.Fil: Bonano, Daniela. Instituto Universidad de la Fundación "Héctor Barceló"; ArgentinaFil: Ochoa, Leandro Javier. Instituto Universidad de la Fundación "Héctor Barceló"; ArgentinaFil: Orzuza, Natalia. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Fernández, Marina A.. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Morra, Ana Paula. Instituto Universidad de la Fundación "Héctor Barceló"; ArgentinaFil: Castro Valdez, Joaquín. Centro de Estudios Legales y Sociales.; ArgentinaFil: Badano, Florencia Maite. Autoridad de Cuenca Matanza Riachuelo.; ArgentinaFil: Ferrando, Fernanda. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Bernasconi, Silvina Virginia. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital General de Agudos Doctor Cosme Argerich.; ArgentinaFil: Turriani, Martín. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Simonini, Claudia. Provincia de Córdoba. Ministerio de Salud; ArgentinaFil: Duarte, Paula. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Ardila Gómez, Sara Elena. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Self-harm consultations during the first year of COVID-19 pandemic: Study in four Argentine provinces

INTRODUCCIÓN: Es objeto de debate si la conducta suicida se vio impactada por la pandemia por COVID-19 y las medidas de aislamiento asociadas. Una vía para caracterizar la conducta suicida son las consultas a los servicios de emergencia en salud por lesiones autoinfligidas. El objetivo fue describir y analizar las consultas por conducta suicida, comparando los períodos de pandemia y prepandemia. MÉTODOS: Se realizó un estudio descriptivo de corte transversal con análisis de fuentes secundarias en tres hospitales generales y tres neuropsiquiátricos de cuatro provincias argentinas. Se relevaron consultas de febrero, julio y octubre del período de estudio. Se midieron variables sociodemográficas y referidas al episodio autolesivo. Se utilizaron frecuencias relativas y tasas para el análisis. RESULTADOS: Se analizaron 411 casos de consulta por lesión autoinfligida. El 73% fue del período previo a 2020. Al comparar los períodos prepandemia y pandemia, se observó un aumento en la tasa de consultas en el segundo, particularmente significativo en los hospitales neuropsiquiátricos. La derivación a otro establecimiento fue mayor en el período de pandemia. El envenenamiento fue el mecanismo de ocurrencia más habitual en ambos períodos, pero disminuyó durante la pandemia, cuando creció el uso de objetos cortantes. DISCUSIÓN: Se requiere continuar con el monitoreo de las consultas por lesiones autoinfligidas y abordar las diferencias de demanda entre hospitales generales y especializados.INTRODUCTION: The impact of COVID-19 pandemic and associated lockdowns on suicide behavior has been a matter of debate. Self-harm consultations to emergency departments are a way to analyze suicidal behavior. The objective was to describe and analyze self-harm consultations, comparing the pandemic and pre-pandemic periods. METHODS: A cross-sectional descriptive study was conducted with secondary source analysis in three general hospitals and three neuropsychiatric hospitals from four Argentine provinces. Consultations reported in February, July and October over the analyzed period were considered for the study. Data gathered included sociodemographic variables and those related to the self-harm event. Relative frequencies and rates were used for the analysis. RESULTS: A total of 411 self-harm consultations were included in the analysis, 73% of them were from the pre-pandemic period. Consultation rates were higher in the pandemic period, with a particularly significant increase in neuropsychiatric hospitals. Referral to another facility was higher during the pandemic. Poisoning was the most frequently used mechanism in both periods, even though it diminished during the pandemic period, when the use of sharp objects increased. DISCUSSION: It is necessary to continue monitoring self-harm consultations, and the differences between demand to general and specialized neuropsychiatric hospitals.Fil: Bonano, Daniela. Instituto Universidad de la Fundación "Héctor Barceló"; ArgentinaFil: Ochoa, Leandro Javier. Instituto Universidad de la Fundación "Héctor Barceló"; ArgentinaFil: Orzuza, Natalia. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Fernández, Marina A.. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Morra, Ana Paula. Instituto Universidad de la Fundación "Héctor Barceló"; ArgentinaFil: Castro Valdez, Joaquín. Centro de Estudios Legales y Sociales.; ArgentinaFil: Badano, Florencia Maite. Autoridad de Cuenca Matanza Riachuelo.; ArgentinaFil: Ferrando, Fernanda. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Bernasconi, Silvina Virginia. Gobierno de la Ciudad Autonoma de Buenos Aires. Hospital General de Agudos Doctor Cosme Argerich.; ArgentinaFil: Turriani, Martín. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Simonini, Claudia. Provincia de Córdoba. Ministerio de Salud; ArgentinaFil: Duarte, Paula. Gobierno de la Provincia de Entre Rios. Ministerio de Salud.; ArgentinaFil: Ardila Gómez, Sara Elena. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

An examination of the psychometric structure of the Multidimensional Pain Inventory in temporomandibular disorder patients: a confirmatory factor analysis

BACKGROUND: This paper seeks to analyse the psychometric and structural properties of the Multidimensional Pain Inventory (MPI) in a sample of temporomandibular disorder patients. METHODS: The internal consistency of the scales was obtained. Confirmatory Factor Analysis was carried out to test the MPI structure section by section in a sample of 114 temporomandibular disorder patients. RESULTS: Nearly all scales obtained good reliability indexes. The original structure could not be totally confirmed. However, with a few adjustments we obtained a satisfactory structural model of the MPI which was slightly different from the original: certain items and the Self control scale were eliminated; in two cases, two original scales were grouped in one factor, Solicitous and Distracting responses on the one hand, and Social activities and Away from home activities, on the other. CONCLUSION: The MPI has been demonstrated to be a reliable tool for the assessment of pain in temporomandibular disorder patients. Some divergences to be taken into account have been clarified

Effects of intubation timing in patients with COVID-19 throughout the four waves of the pandemic : a matched analysis

The primary aim of our study was to investigate the association between intubation timing and hospital mortality in critically ill patients with COVID-19-associated respiratory failure. We also analysed both the impact of such timing throughout the first four pandemic waves and the influence of prior non-invasive respiratory support on outcomes. This is a secondary analysis of a multicentre, observational and prospective cohort study that included all consecutive patients undergoing invasive mechanical ventilation due to COVID-19 from across 58 Spanish intensive care units (ICU) participating in the CIBERESUCICOVID project. The study period was between 29 February 2020 and 31 August 2021. Early intubation was defined as that occurring within the first 24 h of intensive care unit (ICU) admission. Propensity score (PS) matching was used to achieve balance across baseline variables between the early intubation cohort and those patients who were intubated after the first 24 h of ICU admission. Differences in outcomes between early and delayed intubation were also assessed. We performed sensitivity analyses to consider a different timepoint (48 h from ICU admission) for early and delayed intubation. Of the 2725 patients who received invasive mechanical ventilation, a total of 614 matched patients were included in the analysis (307 for each group). In the unmatched population, there were no differences in mortality between the early and delayed groups. After PS matching, patients with delayed intubation presented higher hospital mortality (27.3% versus 37.1%, p =0.01), ICU mortality (25.7% versus 36.1%, p=0.007) and 90-day mortality (30.9% versus 40.2%, p=0.02) when compared to the early intubation group. Very similar findings were observed when we used a 48-hour timepoint for early or delayed intubation. The use of early intubation decreased after the first wave of the pandemic (72%, 49%, 46% and 45% in the first, second, third and fourth wave, respectively; first versus second, third and fourth waves p<0.001). In both the main and sensitivity analyses, hospital mortality was lower in patients receiving high-flow nasal cannula (n=294) who were intubated earlier. The subgroup of patients undergoing NIV (n=214) before intubation showed higher mortality when delayed intubation was set as that occurring after 48 h from ICU admission, but not when after 24 h. In patients with COVID-19 requiring invasive mechanical ventilation, delayed intubation was associated with a higher risk of hospital mortality. The use of early intubation significantly decreased throughout the course of the pandemic. Benefits of such an approach occurred more notably in patients who had received high-flow nasal cannul

Qualitative research on the factors affecting transferability of digital solutions for integrated care

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Effectiveness and Estimation of Cost-Effectiveness of a Group-Based Multicomponent Physical Exercise Programme on Risk of Falling and Frailty in Community-Dwelling Older Adults

This study analyses the effectiveness and cost-effectiveness of a group-based multicomponent physical exercise programme aimed at reducing the risk of falling and frailty in community-dwelling older adults. This is a pretest&ndash;posttest non-equivalent control group design, with an intervention group and a comparison group. Participants were evaluated at baseline and after 9 months. The effectiveness analyses showed significant reduction in the risk of falling (&minus;45.5%; p = 0.000) and frailty (&minus;31%; p = 0.000) after the intervention for the participants in the physical exercise programme. Moreover, these participants showed an improvement in limitations in activities of daily living, self-care ability and the use of health resources, physical performance, balance and body mass index. The cost-effectiveness analyses showed that the intervention was cost-saving and more effective than usual care scenario. A novel group-based multicomponent physical exercise programme showed to be more effective and cost-effective than usual care for older adults suffering from risk of falling and frailty

Los factores psicológicos en el trastorno temporomandibular

Este trabajo analiza el estado actual de la investigación sobre el papel de los factores psicológicos en los trastornos temporomandibulares. Se considera la problemática asociada a la manifestación clínica y criterios diagnósticos de estos trastornos, así como los diferentes planteamientos en torno a su etiología. El artículo incluye los principales hallazgos encontrados sobre la contribución de los factores psicológicos en los trastornos temporomandibulares, describiendo los problemas metodológicos en este campo. Entre estos resultados se analiza la evidencia respecto a la hipótesis psicofisiológica ¿que relaciona el estrés con la etiología de los trastornos temporomandibulares¿; se destaca la existencia de mayores niveles de psicopatología en pacientes temporomandibulares, fundamentalmente en el subtipo muscular; y, finalmente, se considera la contribución de los factores psicológicos cuando los trastornos temporomandibulares se analizan desde la perspectiva del dolor crónico