Sistema Financiero Nacional : Análisis del riesgo crediticio que enfrento el Banco La Fise Bancentro en el periodo 2012-2013

El presente documento abordo los principales riesgos financieros que afecta el sistema bancario nicaragüense, enfocado en el análisis detallado del riesgo crediticio que enfrento el Banco BANCENTRO LAFISE en el periodo 2012-2013, debido a que este tipo de riesgo puede afectar directamente la cartera de las instituciones financieras cuando se realiza un mal análisis en el otorgamiento de crédito, entre otros factores que puedan incidir en el incremento de dicho riesgo. En esta investigación se procedió a recopilar la información sustancial sobre los tipos de riesgos, incluyendo la clasificación y el análisis de la cartera de crédito del Banco BANCENTRO LAFISE en el periodo 2012-2013, logrando documentar el nivel de riesgo al que estuvo expuesto dicho banco en el periodo antes mencionado, resultando con un porcentaje de riesgo para la cartera de crédito que no excede el porcentaje máximo establecido en las normas reguladas por la Superintendencia de Bancos y Otras Instituciones Financieras.LEY 316, Ley General de Bancos y Otras Instituciones Financieras. Con los resultados obtenidos de la investigación lograremos valorar el riesgo crediticio y evaluar la estabilidad financiera de Bancentro Lafise en el periodo 2012-2013. Concluyendo que las instituciones financieras del Sistema bancario nicaragüense están altamente expuestas a enfrentar los riesgos abordados en este documento, por lo que se debe realizar un análisis profundo para el otorgamiento del crédito, así mismo deben tener claramente establecidas sus Políticas de Crédito, ejecutando revisiones periódicas a las mismas para mejorar los procedimientos utilizados, logrando con esto minimizar el riesgo al que se encontraron expuestos en periodos anteriores

Polimedicación, interacciones medicamentosas y prescripción potencialmente inapropiada en personas mayores de 75 años en atención primaria

Introducción: El aumento de la esperanza de vida en los últimos años, así como su proyección futura, hace que los procesos ligados a la comorbilidad también aumenten y, asociado al tratamiento farmacológico para tratar dichos procesos, es inevitable la polimedicación de la que pueden derivar tanto las interacciones medicamentosas como la prescripción potencialmente inapropiada. Los costes en salud y socioeconómicos derivados de estos problemas se han convertido en un área de interés para la salud pública. Diseño: Estudio descriptivo y transversal. Población: Personas mayores de 75 años de un Departamento de Salud, en el ámbito de la atención primaria de la Comunitat Valenciana. Objetivos y métodos: Nuestra investigación pretendió caracterizar las prescripciones farmacológicas y determinar la magnitud de los problemas que se pudieran derivar de ellas, como son la frecuencia de polimedicación, la de interacciones medicamentosas (mediante el programa Bot Plus 2.0 del Consejo General de Colegios de Farmacéuticos de España) y la prescripción potencialmente inapropiada (a través de los criterios STOPP/START). Se determinaron las relaciones estadísticas entre ellas, así como las relaciones con las variables sociodemográficas. Resultados: La polimedicación está presente en el 38.8% de la muestra, las interacciones de relevancia clínica en un 39,5% y la prescripción potencialmente inapropiada en más de la mitad de las personas del estudio. Se ha determinado asociación estadística entre todas ellas mientras que no se relacionan con las variables sociodemográficas (edad, sexo, pertenencia a los centros sanitarios). La probabilidad de sufrir una interacción medicamentosa de evidencia amplia es cinco veces mayor (OR=5.14) si aparece un criterio STOPP. El modelo ajustado por edad y sexo ofrece una variación mínima de 0.04 (OA=5.18) de esa probabilidad. El riesgo de aparecer criterios STOPP cuando se da el suceso de polimedicación es 3,06 veces superior. 4 Conclusiones: Los problemas derivados de la polimedicación se muestran como un problema potencial para la salud de las personas mayores y podrían disminuir aplicando correctamente los criterios STOPP, en especial, las interacciones medicamentosas de relevancia clínica en casi un tercio de las detectadas.Introduction: The increase in life expectancy in recent years, as well as its future projection, causes that the processes linked to comorbidity also increase and, associated to the pharmacological treatment to treat these processes, it is inevitable the polymedication from which they can derive Both drug interactions and potentially inappropriate prescription. The health and socio-economic costs of these problems have become an area of ​​public health concern. Design: Descriptive and cross-sectional study. Population: People older than 75 years of a Department of Health, in the field of primary care in the Region of Valencia. Objectives and methods: Our research aimed to characterize the pharmacological prescriptions and determine the magnitude of the problems that could be derived from them, such as the frequency of polymerization, drug interactions (through the Bot Plus 2.0 program of the General Council of Pharmaceutical Colleges Of Spain) and potentially inappropriate prescription (through the STOPP / START criteria). Statistical relationships were determined between them, as well as the relationships with sociodemographic variables. Results: Polymerization is present in 38.8% of the sample, interactions of clinical relevance in 39.5% and potentially inappropriate prescription in more than half of the people in the study. It has been determined statistical association between all of them while they are not related to sociodemographic variables (age, sex, membership of health centers). The likelihood of a drug-drug interaction with ample evidence is five times greater (OR = 5.14) if a STOPP criterion appears. The model adjusted for age and sex offers a minimum variation of 0.04 (OA = 5.18) of that probability. The risk of STOPP criteria occurring when the polypedic event occurs is 3.06 times higher. 4 CONCLUSIONS: Problems resulting from polypedication are shown to be a potential problem for the health of the elderly and could be reduced by correctly applying the STOPP criteria, especially drug interactions of clinical relevance in almost one third of those detected

Multipolling and OFDMA Reservation Protocol for IEEE 802.11 Networks

This paper presents an efficient multipolling scheme that improves the IEEE 802.11 MAC protocol efficiency and does not suffer from the hidden terminal problem or inefficient channel usage problems. To design an efficient polling scheme, the access point (AP) needs to obtain information about the current transmission status and channel state for each station. In this new scheme, we propose the use of multipolling frames in the downlink and Orthogonal Frequency Division Multiple Access (OFDMA) for the uplink reservation frames in order to reduce signaling overhead.Postprint (published version

Lactoferrin as Immune-Enhancement Strategy for SARS-CoV-2 Infection in Alzheimer's Disease Patients.

Coronavirus 2 (SARS-CoV2) (COVID-19) causes severe acute respiratory syndrome. Severe illness of COVID-19 largely occurs in older people and recent evidence indicates that demented patients have higher risk for COVID-19. Additionally, COVID-19 further enhances the vulnerability of older adults with cognitive damage. A balance between the immune and inflammatory response is necessary to control the infection. Thus, antimicrobial and anti-inflammatory drugs are hopeful therapeutic agents for the treatment of COVID-19. Accumulating evidence suggests that lactoferrin (Lf) is active against SARS-CoV-2, likely due to its potent antiviral and anti-inflammatory actions that ultimately improves immune system responses. Remarkably, salivary Lf levels are significantly reduced in different Alzheimer's disease (AD) stages, which may reflect AD-related immunological disturbances, leading to reduced defense mechanisms against viral pathogens and an increase of the COVID-19 susceptibility. Overall, there is an urgent necessity to protect AD patients against COVID-19, decreasing the risk of viral infections. In this context, we propose bovine Lf (bLf) as a promising preventive therapeutic tool to minimize COVID-19 risk in patients with dementia or AD.This study was supported by grants from Instituto de Salud Carlos III (FIS21/00679 to EC and JH-G and PI21/00183 to FB), FEDER, Comunidad de Madrid (S2017/BMD-3700; NEUROMETAB-CM to EC), and CIBERNED (CB07/502 to EC); Spanish Ministry of Economy and Competitiveness (PID2020-119978RB-I00 to JC), CIBERNED, the Research Program for a Long-Life Society (0551_PSL_6_E to JC), the Junta de Andalucía (PY20_00858 to J.L.C.), the Andalucía-FEDER Program (UPO-1380913 to JC).S

Predictors and consequences of altered mineral metabolism: The Dialysis Outcomes and Practice Patterns Study

Predictors and consequences of altered mineral metabolism: The Dialysis Outcomes and Practice Patterns Study.BackgroundAltered mineral metabolism contributes to bone disease, cardiovascular disease, and other clinical problems in patients with end-stage renal disease.MethodsThis study describes the recent status, significant predictors, and potential consequences of abnormal mineral metabolism in representative groups of hemodialysis facilities (N = 307) and patients (N = 17,236) participating in the Dialysis Outcomes and Practice Patterns Study (DOPPS) in the United States, Europe, and Japan from 1996 to 2001.ResultsMany patients fell out of the recommended guideline range for serum concentrations of phosphorus (8% of patients below lower target range, 52% of patients above upper target range), albumin-corrected calcium (9% below, 50% above), calcium-phosphorus product (44% above), and intact PTH (51% below, 27% above). All-cause mortality was significantly and independently associated with serum concentrations of phosphorus (RR 1.04 per 1 mg/dL, P = 0.0003), calcium (RR 1.10 per 1 mg/dL, P < 0.0001), calcium-phosphorus product (RR 1.02 per 5 mg2/dL2, P = 0.0001), PTH (1.01 per 100 pg/dL, P = 0.04), and dialysate calcium (RR 1.13 per 1 mEq/L, P = 0.01). Cardiovascular mortality was significantly associated with the serum concentrations of phosphorus (RR 1.09, P < 0.0001), calcium (RR 1.14, P < 0.0001), calcium-phosphorus product (RR 1.05, P < 0.0001), and PTH (RR 1.02, P = 0.03). The adjusted rate of parathyroidectomy varied 4-fold across the DOPPS countries, and was significantly associated with baseline concentrations of phosphorus (RR 1.17, P < 0.0001), calcium (RR 1.58, P < 0.0001), calcium-phosphorus product (RR 1.11, P < 0.0001), PTH (RR 1.07, P < 0.0001), and dialysate calcium concentration (RR 0.57, P = 0.03). Overall, 52% of patients received some form of vitamin D therapy, with parenteral forms almost exclusively restricted to the United States. Vitamin D was potentially underused in up to 34% of patients with high PTH, and overused in up to 46% of patients with low PTH. Phosphorus binders (mostly calcium salts during the study period) were used by 81% of patients, with potential overuse in up to 77% patients with low serum phosphorus concentration, and potential underuse in up to 18% of patients with a high serum phosphorus concentration.ConclusionThis study expands our understanding of the relationship between altered mineral metabolism and outcomes and identifies several potential opportunities for improved practice in this area

Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe

Depression as a predictor of mortality and hospitalization among hemodialysis patients in the United States and Europe.BackgroundDepression is not uncommon among patients with end-stage renal disease (ESRD) being treated by hemodialysis. We investigated whether risk of mortality and rate of hospitalization may be predicted from physician-diagnosed depression and patients' self-reports of depressive symptoms.MethodsData were analyzed from the Dialysis Outcomes and Practice Patterns Study (DOPPS) for randomly selected ESRD patients being treated by hemodialysis in the United States (142 facilities, 2855 patients) and five European countries (101 facilities, 2401 patients). The diagnosis of depression during the past year was abstracted from the medical records. In addition, the patients were asked to indicate how much of their time over the previous four weeks they had felt (1) “so down in the dumps that nothing could cheer you up” and (2) “downhearted and blue.” A response of “a good bit,”“most,” or “all” of the time were classified as depressed.ResultsThe prevalence of depression was nearly 20%. The relative risks of mortality and hospitalization among depressed (vs. non-depressed), adjusted for time on dialysis, age, race, socioeconomic status, comorbid indicators and country were, respectively: 1.23 and 1.11 for physician-diagnosed depression, 1.48 and 1.15 for the “so down in the dumps” question, and 1.35 and 1.11 for the “downhearted and blue” question (P < 0.05 for all six relative risks). These associations were not significantly different between US and European patients.ConclusionsSelf-reported depression by two simple questions was associated with increased risks of mortality and hospitalization for hemodialysis patients. Future research needs to assess whether early identification and treatment of depression may help to improve quality of life and survival in hemodialysis patients

Acciones de acogida del proyecto mentor de la EUITI

Desde el curso académico 2008/2009 el Proyecto Mentor de la Escuela Universitaria de Ingeniería Técnica Industrial (EUITI) de la UPM [1] participa en distintas acciones de acogida de los alumnos de nuevo ingreso propio del centro. Estas actividades son el primer contacto de los mentores con los alumnos de nuevo ingreso y además son reforzadas por el apoyo y experiencia de los tutores y mentores del curso anterior, favoreciendo la interrelación de alumnos de distintos cursos y especialidades. Para la correcta realización de estas actividades, los alumnos mentores reciben un intensivo programa de formación que incluye aspectos psicosociales propios de la mentoría [2]. La presente comunicación tiene el propósito de describir dichas acciones así como presentar y valorar los resultados obtenidos a través de la encuest

Turning the Crisis Into an Opportunity: Digital Health Strategies Deployed During the COVID-19 Outbreak

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Digital health; eHealth; Telemedicine; Public healthCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Salud digital; eSalud; Telemedicina; Salud públicaCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Salut digital; eSalut; Telemedicina; Salut públicaDigital health technologies offer significant opportunities to reshape current health care systems. From the adoption of electronic medical records to mobile health apps and other disruptive technologies, digital health solutions have promised a better quality of care at a more sustainable cost. However, the widescale adoption of these solutions is lagging behind. The most adverse scenarios often provide an opportunity to develop and test the capacity of digital health technologies to increase the efficiency of health care systems. Catalonia (Northeast Spain) is one of the most advanced regions in terms of digital health adoption across Europe. The region has a long tradition of health information exchange in the public health care sector and is currently implementin an ambitious digital health strategy. In this viewpoint, we discuss the crucial role digital health solutions play during the coronavirus disease (COVID-19) pandemic to support public health policies. We also report on the strategies currently deployed at scale during the outbreak in Cataloni

Development of a citizen monitoring program for the Barcelona coastal waters: the Scientific Patí Vela

The first results of the PATI CIENTIFIC project are presented. This is a collaborative project funded by a Barcelona Institute of Culture’s grant for research and innovation under the 2019 Barcelona Science Plan. The main objective of this project is to develop a monitoring program for the coastal waters of Barcelona through a small -sailboat fleet of the traditional and sustainable Patí de Vela (sailing skate). This pleasure boat is to become a scientific sailing skate. This fleet will acquire the essential oceanographic variables along the Catalan coast, which will be incorporated and accessible in a web platform. We present the initial adaptations done to the Patí de Vela to have an onboard platform holding the scientific instruments (sensors and devices) for sampling the Barcelona coastal waters. These adaptations allow the systematic measurements of the essential physical and biogeochemical variables. These data, which will allow detecting variations along the coast, hence identifying potential sources of contamination and also providing the necessary knowledge of natural and anthropogenic seasonality, and will be freely available on a web platform. The PATI CIENTIFIC project will increase our knowledge of the coastal waters of the Barcelona coast, encouraging participation in sea monitoring activities and increasing social awareness on the need to love and protect our oceans.Postprint (published version

Nonadherence in hemodialysis: Associations with mortality, hospitalization, and practice patterns in the DOPPS

Nonadherence in hemodialysis: Associations with mortality, hospitalization, and practice patterns in the DOPPS.BackgroundNonadherence among hemodialysis patients compromises dialysis delivery, which could influence patient morbidity and mortality. The Dialysis Outcomes and Practice Patterns Study (DOPPS) provides a unique opportunity to review this problem and its determinants on a global level.MethodsNonadherence was studied using data from the DOPPS, an international, observational, prospective hemodialysis study. Patients were considered nonadherent if they skipped one or more sessions per month, shortened one or more sessions by more than 10 minutes per month, had a serum potassium level openface>6.0mEq/L, a serum phosphate level openface>7.5mg/dL (>2.4mmol/L), or interdialytic weight gain (IDWG)>5.7% of body weight. Predictors of nonadherence were identified using logistic regression. Survival analysis used the Cox proportional hazards model adjusting for case-mix.ResultsSkipping treatment was associated with increased mortality [relative risk (RR) = 1.30, P = 0.01], as were excessive IDWG (RR = 1.12, P = 0.047) and high phosphate levels (RR = 1.17, P = 0.001). Skipping also was associated with increased hospitalization (RR = 1.13, P = 0.04), as were high phosphate levels (RR = 1.07, P = 0.05). Larger facility size (per 10 patients) was associated with higher odds ratios (OR) of skipping (OR = 1.03, P = 0.06), shortening (OR = 1.03, P = 0.05), and IDWG (OR = 1.02, P = 0.07). An increased percentage of highly trained staff hours was associated with lower OR of skipping (OR = 0.84 per 10%, P = 0.02); presence of a dietitian was associated with lower OR of excessive IDWG (OR = 0.75, P = 0.08).ConclusionNonadherence was associated with increased mortality risk (skipping treatment, excessive IDWG, and high phosphate) and with hospitalization risk (skipping, high phosphate). Certain patient/facility characteristics also were associated with nonadherence