INNOVASONORA: gestión de archivos sonoros, sonido inmersivo y realidad virtual en plataformas LMS

Memoria del proyecto de innovación docente "Innovasonora" (Curso 2021-2022

INNOVASONORA: desarrollo de recursos para la transmisión digital de los archivos sonoros y la aplicación de la realidad virtual como complemento de la enseñanza presencial

Memoria del proyecto de innovación docente nº 208 (curso 2020-2021

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Reasons for facebook usage: Data from 46 countries

Seventy-nine percent of internet users use Facebook, and on average they access Facebook eight times a day (Greenwood et al., 2016). To put these numbers into perspective, according to Clement (2019), around 30% of the world\u2019s population uses this Online Social Network (OSN) site. Despite the constantly growing body of academic research on Facebook (Chou et al., 2009; Back et al., 2010; Kaplan and Haenlein, 2010; McAndrew and Jeong, 2012; Wilson et al., 2012; Krasnova et al., 2017), there remains limited research regarding the motivation behind Facebook use across different cultures. Our main goal was to collect data from a large cross-cultural sample of Facebook users to examine the roles of sex, age, and, most importantly, cultural differences underlying Facebook use

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Objetive assessment of sedentary time and physical activity throughout the week in adolescents with Down syndrome. The UP&DOWN study

This study aimed to examine the patterns of sedentary time and physical activity (PA) throughout the week in adolescents with Down syndrome (DS). The study comprised 109 adolescents with DS (68 males and 41 females) aged 11-20 years, participating in the UP&DOWN study, but only a total of 100 adolescents provided valid data. Sedentary time and total, light, moderate, vigorous, and moderate-to-vigorous PA (MVPA) were measured by accelerometers. There were no significant differences in the time spent in sedentary time and PA levels between weekdays vs. weekend days, as well as between school time vs. after school-time periods (all p>0.05). Adolescent males engaged in more total PA, moderate PA, vigorous PA and MVPA than females on weekend days (all p<0.05). Differences between age groups showed that sedentary time increases and PA decreases with advancing age in all analyses, so that the oldest groups were more sedentary and less active (all p<0.05). Only 43% of adolescents with DS met the PA recommendations of ≥60min/day of MVPA. Our findings show valuable information to be considered in future interventions aiming to decrease sedentary time and increase PA levels in adolescents with DS

Verificación de estándares de habilitación en la E.S.E Hospital San José Medellín– Antioquia

En el presente informe describimos la verificación realizada a la E.S.E Hospital San José, donde se evaluaron los siguientes estándares, procesos prioritarios, medicamentos, dispositivos médicos e insumos, dotación e infraestructura, de las dependencias de hospitalización, UCI, imágenes diagnósticas y cirugía de mediana complejidad, el cual realizamos como una oportunidad de aprendizaje, además de comprobar el cumplimiento de la normatividad basada en la resolución 2003 de mayo de 2014,1 “Por la cual se definen los procedimientos y condiciones de inscripción de los Prestadores de Servicios de Salud y de habilitación de servicios de salud” por medio de observación y listas de chequeo, teniendo muy claro 1“la verificación de las condiciones de habilitación para los prestadores de servicios de salud, debe estar orientada hacia situaciones tangibles generadoras de riesgo, siempre sin exceder los estándares planteados” (social, 2014) aportando así recomendaciones de mejora a dicha institución teniendo como producto final un acta de informe, recordemos que siempre se tiene como objetivo mejorar la calidad de servicios prestados centrados en el usuario y la seguridad del mismo.es por eso que la ley es muy clara en las condiciones para prestar un servicio en salud, en donde la calidad es definida en múltiples conceptos y por lo general “coinciden todos en que la calidad gira en torno a la satisfacción del paciente”. (conexionesan, 2016)3. Antecedentes. -- 4. Objetivos. -- 4.1 Objetivo general. -- 4.2 Objetivos específicos. -- 5. Productos. -- Cirugía de media y alta complejidad. -- Guía para la verificación de estándares. -- Del sistema único de habilitación. -- Cuidado intensivo adulto. -- Radiología e imágenes diagnósticas de mediana y alta complejidad. -- Guía para la verificación de estándares. -- Del sistema único de habilitación. -- Procesos prioritarios. -- 6. Alcance. -- 7. Actividades y metodología. -- 8. Diagnósticos – hallazgos. -- 9 Limitaciones y fortalezas. -- 9.1 Limitaciones. -- 9.2 Fortalezas. -- 10. Resultados. -- 11. Conclusiones. -- 12. Recomendaciones. -- 13. Anexos. -- 14.Bibliografía. -

Development And Validation Of The Increment-Esbl Predictive Score For Mortality In Patients With Bloodstream Infections Due To Extendedspectrum- Beta-Lactamase-Producing Enterobacteriaceae

Background. Bloodstream infections (BSIs) due to ESBL-producing Enterobacteriaceae (ESBL-E) are frequent yet outcome prediction rules for clinical use have not been developed. The objective was to define and validate a predictive risk score for 30 day mortality. Methods. A multinational retrospective cohort study including consecutive episodes of BSI due to ESBL-E was performed; cases were randomly assigned to a derivation cohort (DC) or a validation cohort (VC). The main outcome variable was all-cause 30 day mortality. A predictive score was developed using logistic regression coefficients for the DC, then tested in the VC. Results. The DC and VC included 622 and 328 episodes, respectively. The final multivariate logistic regression model for mortality in the DC included age > 50 years (OR = 2.63; 95% CI: 1.18-5.85; 3 points), infection due to Klebsiella spp. (OR = 2.08; 95% CI: 1.21-3.58; 2 points), source other than urinary tract (OR = 3.6; 95% CI: 2.02-6.44; 3 points), fatal underlying disease (OR =3.91; 95% CI: 2.24-6.80; 4 points), Pitt score > 3 (OR =3.04; 95CI: 1.69-5.47; 3 points), severe sepsis or septic shock at presentation (OR = 4.8; 95% CI: 2.72-8.46; 4 points) and inappropriate early targeted therapy (OR = 2.47; 95% CI: 1.58-4.63; 2 points). The score showed an area under the receiver operating curve (AUROC) of 0.85 in the DC and 0.82 in the VC. Mortality rates for patients with scores of = 11 were 5.6% and 45.9%, respectively, in the DC, and 5.4% and 34.8% in the VC. Conclusions. We developed and validated an easy-to-collect predictive scoring model for all-cause 30 day mortality useful for identifying patients at high and low risk of mortality.Wo

Down syndrome as risk factor for respiratory syncytial virus hospitalization : A prospective multicenter epidemiological study

Respiratory syncytial virus (RSV) infection in childhood, particularly in premature infants, is associated with significant morbidity and mortality. To compare the hospitalization rates due to RSV infection and severity of disease between infants with and without Down syndrome (DS) born at term and without other associated risk factors for severe RSV infection. In a prospective multicentre epidemiological study, 93 infants were included in the DS cohort and 68 matched by sex and data of birth (±1 week) and were followed up to 1 year of age and during a complete RSV season. The hospitalization rate for all acute respiratory infection was significantly higher in the DS cohort than in the non-DS cohort (44.1% vs 7.7%, P<.0001). Hospitalizations due to RSV were significantly more frequent in the DH cohort than in the non-DS cohort (9.7% vs 1.5%, P=.03). RSV prophylaxis was recorded in 33 (35.5%) infants with DS. The rate of hospitalization according to presence or absence of RSV immunoprophylaxis was 3.0% vs 15%, respectively. Infants with DS showed a higher rate of hospitalization due to acute lower respiratory tract infection and RSV infection compared to non-DS infants. Including DS infants in recommendations for immunoprophylaxis of RSV disease should be considered