La participación de las autoridades auxiliares municipales como apoyo para fortalecer el gobierno electrónico en el municipio de Lerma, Estado de México

En este trabajo se pretende estudiar el campo de acción en donde se desarrollan e interactúan los dos temas principales de esta investigación, el gobierno electrónico y las autoridades auxiliares. En el primer capítulo se diferenciarán e identificarán conceptos como gobierno, administración pública, municipio y gobierno electrónico, todo ello partiendo del marco teórico para poder pasar al tema de las autoridades auxiliares y su interrelación con el gobierno electrónico. Seguido de ello, en el segundo capítulo se hablará de participación, además de hacerse una descripción de la evolución de las autoridades auxiliares y los cambios que han sufrido a través de la historia de nuestro país, lo que sin duda nos ayudará a conocer la verdadera esencia de esta figura de autoridad. De igual manera, nos abocaremos a definir de manera puntual al gobierno electrónico y a las autoridades auxiliares, además de mencionar sus principales características y como es que el gobierno electrónico es una herramienta interesante que se puede aprovechar en los municipios, y sobre todo en las comunidades con el apoyo de las autoridades auxiliares. Asimismo, analizaremos el marco jurídico en donde esta figura de autoridad sustenta sus funciones y características. Todo ello, pasando de un marco teórico a uno referencial en el Estado de México. Por último, señalaremos algunos datos generales del municipio de Lerma por ser el lugar donde se desarrolla el estudio de caso de esta investigación; además de observar y analizar los resultados que nos arrojó dicho estudio, el cual fue llevado a cabo con una metodología de muestreo no probabilístico denominado causal, en donde nos daremos cuenta de la percepción de los ciudadanos al respecto del gobierno electrónico, de las autoridades auxiliares municipales y lo más importante, la participación de las autoridades auxiliares en el fortalecimiento del gobierno electrónico en sus comunidades

Plan estratégico del sistema universitario posgrado público

El Sistema Universitario Postgrado Público (SUPP) es importante para el desarrollo del Estado, fomenta el mayor acceso de la población a la educación de calidad, genera conocimiento a través de la investigación e impulsa el desarrollo socio económico. La educación, salud y seguridad son las tres funciones principales del Estado, en este sentido, el SUPP se califica como deficiente y es uno de los factores críticos que limita el desarrollo de la competitividad en el Perú. El presente planeamiento estratégico tiene como objetivo convertir al SUPP en uno de los dos mejores sistemas educativos a nivel sudamericano al año 2029 y será reconocido por brindar herramientas de gestión de calidad orientadas a mejorar el desempeño, la competitividad y el desarrollo sostenible fomentando investigación, producción de conocimiento y bienestar social. Para lograr su objetivo, el SUPP tendrá un importante reto para mejorar de manera sostenible la calidad educativa a niveles internacionales, incrementando y fomentando la investigación y desarrollo en distintas áreas de interés socio económico y científico. Para concretar dicho crecimiento deberá enfocarse en fortalecer tres puntos clave que son importantes para asegurar una adecuada transferencia y creación de conocimiento, que son la calidad de docentes, infraestructura adecuada y el enfoque en investigación. Todo ello soportado en una adecuada asignación y control financiero y en el desarrollo de un cluster que potencie todo el sistema educativo nacional.The Public Graduate Educational System (PGES) is important for the development of the State, promotes the access to a larger population to a high quality education, creates knowledge through investigation and stimulates the socio economics development. Education, health and security are the three main functions of the State, in that way, PGES is currently qualified as deficient and that is one of the critical issues that restricts the development of the Peruvian competitiveness. This strategic plan aims to make the PGES into one of the two best graduated educational systems at South American level and be recognized for providing quality management tools to improve the performance, competitiveness and sustainable development by promoting research, production of knowledge and social welfare. In order to achieve these goals, PGES will have an important challenge to improve in a sustainable way the educational quality to international levels, by the increase and foment of investigation and development in different socio economics and scientific areas. To achieve such evolution the PGES should strengthen three key areas that are important to assure an adequate transference and creation of knowledge, that are the quality of teachers, adequate infrastructure and focus on investigation. All supported in an adequate finance allocation and controlling and in the development of a cluster that maximize the integral educational system of the State.Tesi

Oxigenación con membrana extracorpórea en el paciente COVID-19: resultados del Registro Español ECMO-COVID de la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE)

Background and aim: COVID-19 patients with severe heart or respiratory failure are potential candidates for extracorporeal membrane oxygenation (ECMO). Indications and management of these patients are unclear. Our aim is to describe the results of a prospective registry of COVID-19 patients treated with ECMO. Methods: An anonymous prospective registry of COVID-19 patients treated with veno-arterial (V-A) or veno-venous (V-V) ECMO was created on march 2020. Clinical, analytical and respiratory preimplantation variables, implantation data and post-implantation course data were recorded. The primary endpoint was all cause in-hospital mortality. Secondary events were functional recovery and the combined endpoint of mortality and functional recovery in patients followed at least 3 months after discharge. Results: Three hundred and sixty-six patients from 25 hospitals were analyzed, 347 V-V ECMO and 18 V-A ECMO patients (mean age 52.7 and 49.5 years respectively). Patients with V-V ECMO were more obese, had less frequently organ damage other than respiratory failure and needed less inotropic support; Thirty three percent of V-A ECMO and 34.9% of V-A ECMO were discharged (P = NS). Hospital mortality was non-significantly different, 56.2% versus 50.9% respectively, mainly during ECMO therapy and mostly due to multiorgan failure. Other 51 patients (14%) remained admitted. Mean follow-up was 196 +/- 101.7 days (95%CI: 170.8-221.6). After logistic regression, body weight (OR 0.967, 95%CI: 0.95-0.99, P = 0.004) and ECMO implantation in the own centre (OR 0.48, 95%CI: 0.27-0.88, P = 0.018) were protective for hospital mortality. Age (OR 1.063, 95%CI: 1.005-1.12, P = 0.032), arterial hypertension (3.593, 95%CI: 1.06-12.19, P = 0.04) and global (2.44, 95%CI: 0.27-0.88, P = 0.019), digestive (OR 4,23, 95%CI: 1.27-14.07, P = 0.019) and neurological (OR 4.66, 95%CI: 1.39-15.62, P = 0.013) complications during ECMO therapy were independent predictors of primary endpoint occurrence. Only the post-discharge day at follow-up was independent predictor of both secondary endpoints occurrence. Conclusions: Hospital survival of severely ill COVID-19 patients treated with ECMO is near 50%. Age, arterial hypertension and ECMO complications are predictors of hospital mortality, and body weight and implantation in the own centre are protective. Functional recovery is only predicted by the follow-up time after discharge. A more homogeneous management of these patients is warranted for clinical results and future research optimization. (C) 2022 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U

Efecto antilipoperoxidante de Plukenetia volubilis L. (Sacha inchi) en ratas con diabetes inducida por aloxano.

Con el objetivo de  demostrar el efecto  antilipoperoxidante de   Plukenetia volubilis L. (Sacha Inchi). en ratas con diabetes inducida por aloxano. Método: se diseñó  un estudio experimental de casos y controles. 24 ratas con diabetes inducida por aloxano, fueron distribuida al azar en   4 grupos: (G0) Grupo control que recibieron 0,64 ml/kg de etanol,  (G1) Grupo estándar tratado con  de 0,25 ml/kg de vitamina E,  (G2) Grupo Experimental tratado con 120 mg/kg de extracto fluido de Sacha Inchi, (G3) Grupo Experimental tratado con  140 mg/kg de extracto fluido de Sacha Inchi.En todos los especímenes se determinó   nivel sérico de Malon dialdehido (MDA) uno basal y otro a los  16 días de iniciado el experimento.  Resultados: G1 mostró una reducción significativa de los niveles de Malondialdehido (MDA) sérico de 30% con respecto al control. El grupo G2, aproximadamente del 16.18% con respecto al control y el grupo G3 también mostró una reducción significativa del 23.5% con respecto al grupo control. Conclusión: la administración del extracto de hojas de Plukenetia Volubilis L in vivo tiene efecto antilipoperoxidante en ratas.  El mismo que es dependiente de  la dosis  administrada. Palabras clave: lipoperoxidación, glicemia, Plukenetia volubilis L., diabetes, estrés oxidativo

Gamificación en Iberoamérica. Experiencias desde la comunicación y la educación

La presente obra capitular es el resultado de las investigaciones sobre las aplicaciones de la gamificación en contextos múltiples, emergentes provenientes de las comunicaciones presentadas en el Simposio 06 del III Congreso Internacional Comunicación y Pensamiento (Sevilla, España), así como de aquellas presentadas por los miembros del Gamelab UPS, del Proyecto I+D+i Coordinado “Competencias mediáticas de la ciudadanía en medios digitales emergentes (smartphones y tablets): Prácticas innovadoras y estrategias educomunicativas en contextos múltiples” (EDU2015-64015-C3-1-R) (MINECO/FEDER), de la “Red de Educación Mediática” del Programa Estatal de Investigación Científica-Técnica de Excelencia, Subprograma Estatal de Generación de Conocimiento (EDU2016-81772-REDT), financiados por el Fondo Europeo de Desarrollo Regional (FEDER) y Ministerio de Economía y Competitividad de España. En este sentido se busca construir, desde una mirada dual desde Europa y América Latina el primer libro iberoamericano de gamificación, avalado por el Gamelab de la Universidad Politécnica Salesiana (Ecuador), el Proyecto I+D+i EDU2015-64015-C3-1-R, la Red Interuniversitaria Euroamericana de Investigación sobre Competencias Mediáticas para la Ciudadanía (Alfamed), el Laboratorio de Estudios en Comunicación (Ladecom) y el Grupo de Investigación Ágora (PAI-HUM-648) de la Universidad de Huelva (España) y el Grupo de Investigación Estructura, Historia y Contenidos de la Comunicación GREHCCO

Ciencia Odontológica 2.0

Libro que muestra avances de la Investigación Odontológica en MéxicoEs para los integrantes de la Red de Investigación en Estomatología (RIE) una enorme alegría presentar el segundo de una serie de 6 libros sobre casos clínicos, revisiones de la literatura e investigaciones. La RIE está integrada por cuerpos académicos de la UAEH, UAEM, UAC y UdeG

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030