Transformation and innovation of organizational culture in Higher Education Institutions. State of the art and conceptual bases

Este documento analiza el estado del arte y las bases conceptuales sobre la transformación e innovación de la cultura organizacional en Instituciones de Educación Superior. Bajo la modalidad de preguntas orientadoras se dio respuesta a dos cuestionamientos principales: a) ¿Cuáles son los elementos diferenciadores de las organizaciones innovadoras, creativas e inteligentes?, y b) ¿De qué manera una Institución de Educación Superior (IES) puede ser innovadora, creativa e inteligente? Al final, se pudo establecer que para el logro de una IES con estructura organizacional innovadora (contexto real), creativa (alta calidad) e inteligente (experiencia compartida, aprendizaje colectivo y pensamiento sistémico), se requiere del compromiso de cada uno de los actores que conforman la comunidad académica, en la adecuada interpretación del direccionamiento estratégico liderado bajo un modelo de alta gerencia.This document examines the state of the art and conceptual bases of the transformation and innovation of organizational culture in higher education institutions. Thus, the research questions of this document are: a) What are the distinguishing features of innovative, creative and smart organizations? b) How does an institution of higher education can be innovative, creative and smart? In the end, it was concluded that to achieve an innovative organizational structure (real context), creative (high quality) and smart (shared experience, collective learning and systems thinking) organization in the higher education context, requires the participation of each one of the actors and focus groups in the academic community, who must properly interpret the strategic direction proposed by senior management

RyRCa2+ Leak Limits Cardiac Ca2+ Window Current Overcoming the Tonic Effect of Calmodulin in Mice

Ca2+ mediates the functional coupling between L-type Ca2+ channel (LTCC) and sarcoplasmic reticulum (SR) Ca2+ release channel (ryanodine receptor, RyR), participating in key pathophysiological processes. This crosstalk manifests as the orthograde Ca2+-induced Ca2+-release (CICR) mechanism triggered by Ca2+ influx, but also as the retrograde Ca2+-dependent inactivation (CDI) of LTCC, which depends on both Ca2+ permeating through the LTCC itself and on SR Ca2+ release through the RyR. This latter effect has been suggested to rely on local rather than global Ca2+ signaling, which might parallel the nanodomain control of CDI carried out through calmodulin (CaM). Analyzing the CICR in catecholaminergic polymorphic ventricular tachycardia (CPVT) mice as a model of RyR-generated Ca2+ leak, we evidence here that increased occurrence of the discrete local SR Ca2+ releases through the RyRs (Ca2+ sparks) causea depolarizing shift in activation and a hyperpolarizing shift inisochronic inactivation of cardiac LTCC current resulting in the reduction of window current. Both increasing fast [Ca2+]i buffer capacity or depleting SR Ca2+ store blunted these changes, which could be reproduced in WT cells by RyRCa2+ leak induced with Ryanodol and CaM inhibition.Our results unveiled a new paradigm for CaM-dependent effect on LTCC gating and further the nanodomain Ca2+ control of LTCC, emphasizing the importance of spatio-temporal relationships between Ca2+ signals and CaM function

Recommendations for treatment with recombinant human growth hormone in pediatric patients in Colombia

En Colombia, actualmente no existen parámetros claros para el diagnóstico de pacientes con talla baja, ni sobre el tratamiento de esta población con hormona de crecimiento recombinante humana (somatropina), lo cual se ve favorecido por la diversidad de programas de formación de profesionales en endocrinología pediátrica. En respuesta a esta problemática se realizó el primer acuerdo colombiano de expertos en talla baja liderado por la Asociación Colegio Colombiana de Endocrinología Pediátrica (ACCEP); este trabajo contó con la participación y el aval de expertos clínicos de importantes instituciones de salud públicas y privadas del país, además de expertos metodológicos del instituto Keralty, quienes garantizaron la estandarización del uso de la somatropina. Después de realizar una minuciosa revisión de la literatura, se propone la unificación de definiciones, un algoritmo diagnóstico, los parámetros de referencia de las pruebas bioquímicas y dinámicas, una descripción de las consideraciones de uso de la somatropina para el tratamiento de las patologías con aprobación por la entidad regulatoria de medicamentos y alimentos en Colombia y, por último, un formato de consentimiento informado y de ficha técnica del medicamento.In Colombia there are no guidelines for diagnosis and management of patients with short stature and for the use of recombinanthuman growth hormone, mainly caused by the diversity of training centers in pediatric endocrinology. In response to this situation,the Asociación Colegio Colombiana de Endocrinología Pediátrica leds the first colombian short stature expert committee in order tostandardize the use of human recombinant growth hormone. This work had the participation and endorsement of a consortium ofclinical experts representing the Sociedad Colombiana de Pediatría, Secretaría Distrital de Salud de Bogotá- Subred Integrada deServicios de Salud Suroccidente, Fundación Universitaria Sanitas, Universidad de los Andes and some public and private healthinstitutions in the country, in addition to the participation of methodological experts from the Instituto Global de Excelencia ClínicaKeralty. By reviewing the literature and with the best available evidence, we proposed to unify definitions, a diagnostic algorithm,biochemical and dynamic tests with their reference parameters, a description of the considerations about growth hormone use amongthe indications approved by regulatory agency for medications and food in Colombia and finally a proposal for an informed consentand a medication fact sheet available for parents and patients.https://orcid.org/0000-0002-7856-7213https://orcid.org/0000-0003-2241-7854Revista Nacional - Indexad

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Proposal of material equipments and basic devices for the operation of occupational therapy services in hospital fields in the area physical dysfunction.

Este trabajo de grado recopila información acerca de los materiales, equipos e instrumentos básicos para la intervención de terapia ocupacional en disfunciones físicas. Primero se realizó una conceptualización en la que se definían claramente estos parámetros basados en la definiciones de tecnología biomédica, según la legislación expedida por el Ministerio de la Protección Social, y el antiguo Ministerio de Salud , se encuentran los últimos lineamentos propios de terapia ocupacional de los requisitos básicos para el funcionamientos de los servicios en los diferentes niveles de complejidad, y se realiza un paralelo entre los requisitos de la normatividad vigente a nivel nacional y la legislación internacional. Se presenta una propuesta de cincuenta equipos, cuarenta y dos materiales y quince instrumentos básicos para el funcionamiento de los servicios de terapia ocupacional para la intervención en consulta externa en el área de disfunciones físicas. Esta propuesta se fundamentó en las herramientas más aplicadas en los marcos de referencia propios de terapia ocupacional que abordan el área de disfunciones físicas, y fue aprobada por cuarenta y una terapeutas ocupacionales que se desempeñan en instituciones hospitalarias en servicios de terapia ocupacional de los niveles de alta , media y baja complejidad. / Abstract. This paper compiles information about the basic materials, equipments and instruments used in physical dysfunction occupational therapy. First of all, some parameters were clearly delimitated based on biomedical technology definitions, according to the Social Protection Ministry, former Health Ministry. The latest policies were cited respecting to the basic requirements for occupational therapy functional services from all the complexity levels. Furthermore, a parallel is made of the current local policies and international requirements. Finally, fifty items of equipment, forty two materials and fifteen basic instruments are proposed to be used in the appropriate functioning of the occupational therapy services working in the area of physical dysfunction. These items have been proposed for external consultation, based on the reference and theoretical framework of the physical dysfunction occupational therapy itself, and had been approved by forty one occupational therapists working in hospitals of different levels of complexity.Terapeuta Ocupacional.Pregrad

Reconciling depressed Ca2+ sparks occurrence with enhanced RyR2 activity in failing mice cardiomyocytes

Abnormalities in cardiomyocyte Ca2+ handling contribute to impaired contractile function in heart failure (HF). Experiments on single ryanodine receptors (RyRs) incorporated into lipid bilayers have indicated that RyRs from failing hearts are more active than those from healthy hearts. Here, we analyzed spontaneous Ca2+ sparks (brief, localized increased in [Ca2+](i)) to evaluate RyR cluster activity in situ in a mouse post-myocardial infarction (PMI) model of HF. The cardiac ejection fraction of PMI mice was reduced to. 30% of that of sham-operated (sham) mice, and their cardiomyocytes were hypertrophied. The [Ca2+](i) transient amplitude and sarcoplasmic reticulum (SR) Ca2+ load were decreased in intact PMI cardiomyocytes compared with those from sham mice, and spontaneous Ca2+ sparks were less frequent, whereas the fractional release and the frequency of Ca2+ waves were both increased, suggesting higher RyR activity. In permeabilized cardiomyocytes, in which the internal solution can be controlled, Ca2+ sparks were more frequent in PMI cells (under conditions of similar SR Ca2+ load), confirming the enhanced RyR activity. However, in intact cells from PMI mice, the Ca2+ sparks frequency normalized by the SR Ca2+ load in that cell were reduced compared with those in sham mice, indicating that the cytosolic environment in intact cells contributes to the decrease in Ca2+ spark frequency. Indeed, using an internal "failing solution" with less ATP (as found in HF), we observed a dramatic decrease in Ca2+ spark frequency in permeabilized PMI and sham myocytes. In conclusion, our data show that, even if isolated RyR channels show more activity in HF, concomitant alterations in intracellular media composition and SR Ca2+ load may mask these effects at the Ca2+ spark level in intact cells. Nonetheless, in this scenario, the probability of arrhythmogenic Ca2+ waves is enhanced, and they play a potential role in the increase in arrhythmia events in HF patients

Calcium signaling in diabetic cardiomyocytes

International audienc