Planeamiento estratégico para el sector de las tecnologías de información y comunicaciones en Colombia

El sector de las Tecnologías de Información y de las Comunicaciones (TIC) en Colombia es transversal a todas las industrias del país, llegando a aportar en 2016 el 3.01% del producto bruto interno (PBI) y a ocupar el puesto 5 en Latinoamérica según el Índice Global de Innovación (GII, por sus siglas en inglés) y el puesto 83 entre 175 en el Índice de Desarrollo (IDI) en 2017. Es un sector en continua evolución dentro de un mercado creciente en los subsectores de software, servicios de TI, y hardware y, en un mercado maduro en el subsector de telecomunicaciones. Sin embargo, enfrenta hoy los retos de las tecnologías emergentes, la economía digital, y la competitividad global que traen consigo para el país, necesidades como el desarrollo de nuevas competencias para la fuerza laboral, ajustes a la legislación tecnológica, mayores niveles de penetración y apropiación de las TIC, incremento de la inversión en I+D, y superar los desafíos de una economía de lento crecimiento. En el presente documento, se desarrolla el Planeamiento Estratégico para el Sector de las TIC en Colombia, comenzando por un análisis macro del sector en el mundo, luego en la región latinoamericana, y finalmente revisando las condiciones políticas, económicas, sociales, tecnológicas, y ecológicas del entorno colombiano y de su potencial como país, identificando las oportunidades y amenazas existentes, así como sus fortalezas y debilidades, para así llegar a la definición de los objetivos a largo y corto plazo y las estrategias necesarias para alcanzar la visión propuesta. Se retuvieron 15 estrategias finales que se enfocaron principalmente en el desarrollo de habilidades TIC, el mejoramiento de la infraestructura y de su cobertura en el ámbito nacional, la ampliación del portafolio de bienes y servicios de alta calidad y competitividad que generen más bienestar, empleo, e inclusión social, la obtención de mayores niveles de captación de inversión, y en el incremento de la capacidad de investigación e innovación para el desarrollo del sectorThe Information and Communications Technology (ICT) sector in Colombia is crossindustry all over the country, contributed to the 3.01% of the GDP by 2016 and it was ranked as number 5 in Latin America according to the Global Innovation Index (GII) and 83rd out of 175 countries in the IDI Development Index at 2017. It is a sector in continuous evolution in a growing market for the subsectors of software, IT services and hardware and in a mature subsector of telecommunications. However, nowadays, the emerging economies, the digital economy and the global competitiveness bring for the country the need to develop new competencies for the labor force, adjustments to the technological legislation, higher levels of penetration and appropriation of ICT, increased investment in R&D and overcome the challenges of a slow-growing economy. This document presents the Strategic Planning developed for the Information and Communication Technologies Sector of Colombia, starting with a world-wide macro analysis of the sector, then for the Latin American region and finally of the political, social, technological conditions and ecological aspects of the Colombian environment and the country potential, identifying current opportunities and threats, as well as the strengths and weaknesses of the sector, in order to define long and short-term objectives and the needed strategies to achieve the vision proposed. Fifteen final strategies were retained that focus mainly on the development of ICT skills, the improvement of infrastructure and coverage at the national level, the expansion of a high quality and competitive goods and services portfolio that generates more well-being, employment and social inclusion, obtaining higher levels of investment and increasing research and innovation capacity that contributes to the development of the sectorTesi

Differences in the Clinical Profile and Management of Atrial Fibrillation According to Gender. Results of the REgistro GallEgo Intercéntrico de Fibrilación Auricular (REGUEIFA) Trial

[Abstract] To analyze the clinical profile and therapeutic strategy in atrial fibrillation (AF) according to gender in a contemporaneous patient cohort a prospective, multicenter observational study was performed on consecutive patients diagnosed with AF and assessed by cardiology units in the region of Galicia (Spain). A total of 1007 patients were included, of which 32.3% were women. The mean age of the women was significantly greater than that of the men (71.6 versus 65.7 years; p < 0.001), with a higher prevalence of hypertension (HTN) and valve disease. Women more often reported symptoms related to arrhythmia (28.2% in EHRA class I versus 36.4% in men), with a poorer level of symptoms (EHRA classes IIb and III). Thromboembolic risk was significantly higher among women (CHA2DS2-VASc 3 ± 1.3 versus 2 ± 1.5), in the same way as bleeding risk (HAS-BLED 0.83 ± 0.78 versus 0.64 ± 0.78) (p < 0.001), and women more often received anticoagulation therapy (94.1% versus 87.6%; p = 0.001). Rhythm control strategies proved significantly less frequent in women (55.8% versus 66.6%; p = 0.001), with a lesser electrical cardioversion (ECV) rate (18.4% versus 27.3%; p = 0.002). Perceived health status was poorer in women. Women were older and presented greater comorbidity than men, with a greater thromboembolic and bleeding risk. Likewise, rhythm control strategies were less frequent than in men, despite the fact that women had poorer perceived quality of life and were more symptomatic

Effect of atrioventricular optimization on circulating N-terminal pro brain natriuretic peptide following cardiac resynchronization therapy.

AIMS: Following CRT, atrioventricular (AV) optimization is not routinely practised. To evaluate its clinical utility, we examined the effect of AV delay optimization on the prognostic biomarker NT-proBNP. METHODS AND RESULTS: We prospectively studied 72 patients (mean age 73 ± 12.5 years, 70.8% male, 55.6% ischaemic) undergoing iterative AV optimization. Patients were divided into those whose nominal setting appeared ideal and not changed (Group 1, n = 22) and those whose AV delay was optimized (Group 2, n = 50). All patients underwent NT-proBNP assessment prior to CRT, and pre- and a median 5 days post-optimization. Compared with Group 1, NT-proBNP fell significantly in Group 2 patients (median 474 pg/mL) following optimization (P = 0.00001). A significant change in filling pattern (defined as a change in AV delay >50 ms) was required in 30% of patients, and it was this subgroup that derived the greater reduction in NT-proBNP levels [-1407 pg/mL, interquartile range (IQR) -3042 to -346 pg/mL] compared with those requiring <50 ms AV delay change (-125 pg/mL, IQR -1038 to 6 pg/mL), P = 0.0011. The benefit of AV optimization was principally observed in reverse remodelling non-responders (median -2167 pg/mL, IQR -3042 to -305 pg/mL) and in patients with a pseudonormal or restrictive filling pattern (median -1407 pg/mL, IQR -2809 to -342 pg/mL), compared with those with more benign diastolic filling (median - 264 pg/mL, IQR -1038 to -21 pg/mL), P = 0.033. CONCLUSIONS: In one-third of patients, major filling pattern changes are achieved with AV optimization, associated with subsequent rapid falls in NT-proBNP. The greater the AV delay change, the larger the NT-proBNP fall, and non-responders and those with restrictive or pseudonormal filling despite CRT are most likely to benefit

Rationale and design of the pragmatic clinical trial tREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fracTion (REBOOT).

There is a lack of evidence regarding the benefits of β-blocker treatment after invasively managed acute myocardial infarction (MI) without reduced left ventricular ejection fraction (LVEF). The tREatment with Beta-blockers after myOcardial infarction withOut reduced ejection fracTion (REBOOT) trial is a pragmatic, controlled, prospective, randomized, open-label blinded endpoint (PROBE design) clinical trial testing the benefits of β-blocker maintenance therapy in patients discharged after MI with or without ST-segment elevation. Patients eligible for participation are those managed invasively during index hospitalization (coronary angiography), with LVEF >40%, and no history of heart failure (HF). At discharge, patients will be randomized 1:1 to β-blocker therapy (agent and dose according to treating physician) or no β-blocker therapy. The primary endpoint is a composite of all-cause death, non-fatal reinfarction, or HF hospitalization over a median follow-up period of 2.75 years (minimum 2 years, maximum 3 years). Key secondary endpoints include the incidence of the individual components of the primary composite endpoint, the incidence of cardiac death, and incidence of malignant ventricular arrhythmias or resuscitated cardiac arrest. The primary endpoint will be analysed according to the intention-to-treat principle. The REBOOT trial will provide robust evidence to guide the prescription of β-blockers to patients discharged after MI without reduced LVEF.REBOOT is a non-commercial trial whose main sponsor is the Spanish National Center for Cardiovascular Research (CNIC). The study also received partial funding from the BI group through the CIBERCV network.S

Rate-adaptive AV delay and exercise performance following cardiac resynchronization therapy.

BACKGROUND: Physiological shortening of the atrioventricular (AV) interval with increasing heart rate is well documented in normal human beings and is an established component of dual-chamber pacing for bradycardia. OBJECTIVES: To assess the effect of exercise on optimal AV delay and the impact of a patient-specific rate-adaptive AV delay (RAAVD) on exercise capacity in patients with heart failure following cardiac resynchronization therapy. METHODS: Phase 1: We performed iterative AV optimization at rest and exercise in 52 cardiac resynchronization therapy patients in atrial-sensed mode (mean age 71.6 ± 9.2 years, 25% females). Phase 2: Subsequently, 20 consecutive volunteers from this group (mean age 69.2 ± 9.6 years, 15% females) underwent cardiopulmonary exercise testing with RAAVD individually programmed ON (RAAVD-ON) or OFF (RAAVD-OFF). RESULTS: Phase 1: In 94% of the patients, there was a marked reduction (mean 50%) in optimal AV delay with exercise. The optimal resting vs exercise AV delay was 114.2 ± 29 ms at a heart rate of 64.4 ± 7.1 beats/min vs 57 ± 31 ms at a heart rate of 103 ± 13 beats/min (P < .001). No patients required an increase in AV delay with exercise, and 3 (6%) showed no change. Phase 2: With RAAVD-ON, significantly better exercise times were achieved (8.7 ± 3.2 minutes) compared with RAAVD-OFF (7.9 ± 3.2 minutes; P = .003), and there was a significant improvement in Vo(2)max (RAAVD-ON 16.1 ± 4.0 vs RAAVD-OFF 14.9 ± 3.7 mL/(kg · min); P = .024). CONCLUSIONS: There was a dramatic reduction in optimal AV delay with physiological exercise in the majority of this heart failure cardiac resynchronization therapy cohort. Replicating this physiological response with a programmable RAAVD translated into a 10% improvement in exercise capacity

Early Tracheostomy for Managing ICU Capacity During the COVID-19 Outbreak: A Propensity-Matched Cohort Study

10 p.Background: During the first wave of the COVID-19 pandemic, shortages of ventilators and ICU beds overwhelmed health care systems. Whether early tracheostomy reduces the duration of mechanical ventilation and ICU stay is controversial. Research question: Can failure-free day outcomes focused on ICU resources help to decide the optimal timing of tracheostomy in overburdened health care systems during viral epidemics? Study design and methods: This retrospective cohort study included consecutive patients with COVID-19 pneumonia who had undergone tracheostomy in 15 Spanish ICUs during the surge, when ICU occupancy modified clinician criteria to perform tracheostomy in Patients with COVID-19. We compared ventilator-free days at 28 and 60 days and ICU- and hospital bed-free days at 28 and 60 days in propensity score-matched cohorts who underwent tracheostomy at different timings (≤ 7 days, 8-10 days, and 11-14 days after intubation). Results: Of 1,939 patients admitted with COVID-19 pneumonia, 682 (35.2%) underwent tracheostomy, 382 (56%) within 14 days. Earlier tracheostomy was associated with more ventilator-free days at 28 days (≤ 7 days vs > 7 days [116 patients included in the analysis]: median, 9 days [interquartile range (IQR), 0-15 days] vs 3 days [IQR, 0-7 days]; difference between groups, 4.5 days; 95% CI, 2.3-6.7 days; 8-10 days vs > 10 days [222 patients analyzed]: 6 days [IQR, 0-10 days] vs 0 days [IQR, 0-6 days]; difference, 3.1 days; 95% CI, 1.7-4.5 days; 11-14 days vs > 14 days [318 patients analyzed]: 4 days [IQR, 0-9 days] vs 0 days [IQR, 0-2 days]; difference, 3 days; 95% CI, 2.1-3.9 days). Except hospital bed-free days at 28 days, all other end points were better with early tracheostomy. Interpretation: Optimal timing of tracheostomy may improve patient outcomes and may alleviate ICU capacity strain during the COVID-19 pandemic without increasing mortality. Tracheostomy within the first work on a ventilator in particular may improve ICU availability

Experiencias en el aula: tercer encuentro de prácticas pedagógicas innovadoras.

Experiencias de profesores en su quehacer en los distintos ambientes de aprendizaje presenciales y a distancia.Para el Centro de Excelencia Docente aeiou constituye un honor presentar la publicación del Tercer Encuentro de Prácticas Pedagógicas Innovadoras en el que se destacan cuarenta trabajos de profesores de UNIMINUTO provenientes de diferentes sedes. Con este encuentro son ya tres que bajo la dirección de aeiou los profesores han compartido su quehacer en los distintos ambientes de aprendizaje presenciales y a distancia. Cada año el Centro de Excelencia Docente invita a los profesores a participar en este evento, para el 2108 además de la inscripción voluntaria por parte de cada profesor, se invitó al estudiantado a que postularan a sus profesores que consideraban eran innovadores y creativos en el cumplimiento de su función docente y se obtuvo una respuesta importante por parte de los estudiantes, que para algunos profesores resultó sorpresiva porque quizás no habían considerado que el trabajo que hacían en su ambiente de aprendizaje era diferente, fuera de lo común. Luego de una evaluación de jurados nacionales e internacionales de las prácticas presentadas y de la realización del evento, que tuvo como novedad hacerlo de forma simultánea en cuatro sedes donde UNIMINUTO tiene presencia: Buga, Ibagué, Pereira y Bogotá, se comparte la presente publicación para tener como referencia y evidencia el trabajo que los profesores hacen a diario

MAGIC and H.E.S.S. detect VHE gamma rays from the blazar OT081 for the first time: a deep multiwavelength study

https://pos.sissa.it/395/815/pdfPublished versio