Implementation of Telemedicine Services in Lower-Middle Income Countries: Lessons for the Philippines

Regardless of the promising potential of telemedicine to address healthcare problems, especially in lower-middle income countries, its success rate has been unsatisfactory and many telemedicine services fail to sustain their implementation shortly after initial funding or after a pilot phase. Therefore, it is important to document existing models of telemedicine implementation in these countries, to identify commonalities and extract experiences that would be useful for implementers, policy makers and future researchers. This review seeks to review and describe the experience of Low and Middle Income Countries (LMICs) in implementing telemedicine services. Evidence extracted from the included studies were analysed through a narrative synthesis which suggests a multi-sectoral approach for implementing telemedicine. It highlights the importance of education, financing options, policy, technology, governance, and partnership, in the wider picture of a sustainable telemedicine implementation among developing countries such as the Philippines. Moreover, the literature reveals both top-down and bottom-up approach for successful telemedicine implementation. These approaches include strengthening the local health workers and integrating telemedicine into the health system. Studies included in this review have been helpful, but there is an obvious lack of studies with high level of evidence that can yield generalisable, thus findings must be inferred with prudence. Even so, this review described and summarised the data which allowed description of factors and lessons in the implementation of telemedicine in LMICs

Análisis inteligente de redes sociales: aproximación a un modelo de red social privada

Hablar de redes sociales inmediatamente lleva a pensar en Facebook o Twitter, pero el análisis de redes sociales tiene raíces más profundas y arraigadas en el tiempo. El análisis de redes sociales, junto con las herramientas tradicionales de análisis de medios sociales, puede ayudar a poner orden y racionalizar este enorme volumen de información. En ese sentido, las redes sociales digitales han crecido exponencialmente, y permiten almacenar muchísima información privada de sus usuarios y sus interacciones. Esto hace que la propagación de los datos de usuarios tiende a ser muy rápida y descontrolada. Su forma de trabajar responde al paradigma: “permitir por defecto”, buscando la personalización con medidas restrictivas posteriores. Este trabajo ha planteado una primera aproximación práctica de un modelo de red social que permita la configuración fácil e intuitiva de los perfiles de los usuarios. Y el diseño de un filtrado inteligente para determinar los grados de afinidad entre usuarios de la red y aumentar la protección de los datos compartidos por los usuarios. Como resultado de esto se ha obtenido la descripción de un modelo, los atributos públicos y privados del usuario, con las funciones que miden la afinidad entre diferentes características de los usuarios.Sociedad Argentina de Informática e Investigación Operativa (SADIO

Formulación de una métrica en la evaluación de los sistemas operativos en tiempo real para sistemas embebidos

The fundamental requirements to be successful for a project of a digital system are: • Appropriate technological solution to the problem • The quick time-to-market solution. On the first point, there are many tools and methods to find a suitable solution cost / performance On the second point, the market offers low cost assembled and tested boards which are efficient for small productions or good basis for developing a dedicated circuit for large productions. Today every circuit must be accompanied by a program that will command it. This is where a bottleneck for getting a product in the shortest possible time may occur. For this reason is that they have developed real-time operating systems that serve as solid basis for the specific program that will solve the problem. This is why Real-Time Operating Systems were developed, serving as a solid basis for the specific program that will solve the problem. The aim of this paper is to propose some methods to evaluate different RTOS, and provide the designer with tools that help him to select the most appropriate for his project.Sección: Diseño de Soft, SO y otrosCentro de Técnicas Analógico-Digitale

Morphoanatomic study of two species commercialized as “topasaire” or “tupisaire” in Jujuy province, Argentina

Argyrochosma nivea (Poir.) Windham (Pteridaceae) y Gaillardia megapotamica (Spreng.) Baker (Asteraceae) son especies empleadas en la medicina tradicional que se expenden en áreas urbanas como "topasaire" o "tupisaire". El objetivo del trabajo es aportar caracteres de valor diagnóstico para diferenciar ambas especies cuando son expendidas de forma trozada. Se empleó el método micrográfico para el análisis de muestras comerciales secas. A nivel morfoanatómico, A. nívea var. nivea presenta frondes con láminas 2-3 imparipinnadas; pínnulas orbiculares, ovadas o elípticas, cortamente pecioluladas; pelos glandulares productores de ceras blancas en cara abaxial; esporas triletes de color marrón claro a oscuro; células epidérmicas isodiamétricas a rectangulares lobuladas de paredes sinuosas; estomas de tipo actinocítico, anisocítico, polocítico y diacítico. G. megapotamica var. radiata presenta hojas alternas lanceoladas, pinatisectas; capítulos radiados con flores amarillas; células poliédricas y de paredes lisas; estomas tipo anomocítico y actinocítico, siendo los primeros más frecuentes; cristales de oxalato de calcio; granos de polen tricolporados, equinados; pelos eglandulares pluricelulares con célula apical de extremo aguzado; tricoma glandular sésil con cabeza bicelular y pelos glandulares capitados biseriados. Se concluye que las características morfoanatómicas descriptas aportan información de valor diagnóstico para el control de calidad farmacobotánico de estas muestras comerciales, especialmente cuando se encuentran trozadas.Argyrochosma nivea (Poir.) Windham (Pteridaceae) and Gaillardia megapotamica (Spreng.) Baker (Asteraceae), are species used in the folk medicine that are sold in urban areas as “topasaire” or “tupisaire”. The objective of this work it is to provide characters of diagnostic value to differentiate both species when they are expended in pieces form. The micrographic method was used for the analysis of dry commercial samples. At the morphoanatomic level, A. nivea var. nivea has fronds with 2-3 imparipinnate blades; orbicular pinnules, ovate or elliptical, short petioled; glandular hairs producing white waxes on abaxial face; trilete spores light to dark brown; isodiametric to rectangular lobed epidermal cells with sinuous walls; actinocytic, anisocytic, paracytic and diacytic stomata. G. megapotamica var. radiata has alternate pinnatisect lanceolate leavest; radiate capitulum, with yellow flowers; smooth-walled and polyhedral cells; anomocytic and actinocytic stomata, the former being the most frequent; calcium oxalate crystals; tricolporate echinate pollen grains; multicellular eglandular hairs with pointed end apical cell; sessile glandular trichome with bicellular head; glandular, capitate biseriate hairs. It is concluded that the described morphoanatomical characteristics provide information of diagnostic value for the pharmacobotanical quality control of the commercial samples, especially when they are chopped.Fil: Sandoval, Carina Yésica. Universidad Nacional de Jujuy. Facultad de Ciencias Agrarias. Centro de Investigaciones y Estudios de Diversidad Vegetal.; Argentina. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; ArgentinaFil: Wagner, Marcelo Luis. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Farmacología; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Departamento de Farmacología. Cátedra de Farmacobótanica; ArgentinaFil: Romeo, Raquel Ángela. Universidad Nacional de Jujuy. Facultad de Ciencias Agrarias. Centro de Investigaciones y Estudios de Diversidad Vegetal.; Argentin

Abordaje innovador en la integración de actividades curriculares del área digital de la carrera de Ingeniería Electrónica

About fifteen years ago, the Electronic Engineering Department of the National Technological University of Buenos Aires was structured grouping the curricula in Knowledge Areas. One of them was the Digital Area. It was assumed that its contents should be changing continuously with the evolution of the technology so a particular coordination effort should be taken in order to provide to the students a complete understanding base to facilitate their performance in the first professional job or in the access to an investigator career. It was accepted that a real project (including circuit design, simulation, firmware, software design, prototype construction, testing and optimization) should be recommended as mandatory to promote the assignatures. A common functional test should be applied to all the area students to simulate (as near as possible) the evaluation of their projects in a real world job or laboratory.Red de Universidades con Carreras en Informática (RedUNCI

Abordaje innovador en la integración de actividades curriculares del área digital de la carrera de Ingeniería Electrónica

About fifteen years ago, the Electronic Engineering Department of the National Technological University of Buenos Aires was structured grouping the curricula in Knowledge Areas. One of them was the Digital Area. It was assumed that its contents should be changing continuously with the evolution of the technology so a particular coordination effort should be taken in order to provide to the students a complete understanding base to facilitate their performance in the first professional job or in the access to an investigator career. It was accepted that a real project (including circuit design, simulation, firmware, software design, prototype construction, testing and optimization) should be recommended as mandatory to promote the assignatures. A common functional test should be applied to all the area students to simulate (as near as possible) the evaluation of their projects in a real world job or laboratory.Red de Universidades con Carreras en Informática (RedUNCI

In Vitro Antifungal Activity of Ibrexafungerp (SCY-078) Against Contemporary Blood Isolates From Medically Relevant Species of Candida: A European Study

BackgroundIbrexafungerp (SCY-078) is the newest oral and intravenous antifungal drug with broad activity, currently undergoing clinical trials for invasive candidiasis. ObjectiveThe aim of this study was to assess the in vitro activity of ibrexafungerp and comparators against a collection of 434 European blood isolates of Candida. MethodsIbrexafungerp, caspofungin, fluconazole, and micafungin minimum inhibitory concentrations (MICs) were collected from 12 European laboratories for 434 blood isolates, including 163 Candida albicans, 108 Candida parapsilosis, 60 Candida glabrata, 40 Candida tropicalis, 29 Candida krusei, 20 Candida orthopsilosis, 6 Candida guilliermondii, 2 Candida famata, 2 Candida lusitaniae, and 1 isolate each of Candida bracarensis, Candida catenulata, Candida dubliniensis, and Candida kefyr. MICs were determined by the EUCAST broth microdilution method, and isolates were classified according to recommended clinical breakpoints and epidemiological cutoffs. Additionally, 22 Candida auris from different clinical specimens were evaluated. ResultsIbrexafungerp MICs ranged from 0.016 to >= 8 mg/L. The lowest ibrexafungerp MICs were observed for C. albicans (geometric MIC 0.062 mg/L, MIC range 0.016-0.5 mg/L) and the highest ibrexafungerp MICs were observed for C. tropicalis (geometric MIC 0.517 mg/L, MIC range 0.06->= 8 mg/L). Modal MICs/MIC(50)s (mg/L) against Candida spp. were 0.125/0.06 for C. albicans, 0.5/0.5 for C. parapsilosis, 0.25/0.25 for C. glabrata, 0.5/0.5 for C. tropicalis, 1/1 for C. krusei, 4/2 for C. orthopsilosis, and 0.5/0.5 for C. auris. Ibrexafungerp showed activity against fluconazole- and echinocandin-resistant isolates. If adopting wild-type upper limits, a non-wild-type phenotype for ibrexafungerp was only observed for 16/434 (3.7%) isolates: 11 (4.6%) C. parapsilosis, 4 (5%) C. glabrata, and 1 (2.5%) C. tropicalis. ConclusionIbrexafungerp showed a potent in vitro activity against Candida.This study received funding from SCYNEXIS. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of the article, or the decision to submit it for publication. CM-A is a recipient of a grant from Fundació n ONCE (Oportunidad al Talento). EE, AG, NJ, CM-A, and GQ have received grant support from Consejerı́a de Educación, Universidades e Investigación del Gobierno Vasco (GIC15 IT-990-16), Fondo de Investigación Sanitaria del Gobierno de España (FIS PI11/00203), and UPV/EHU (UFI 11/25). All authors declare no other competing interests

Long-term thermal sensitivity of Earth’s tropical forests

The sensitivity of tropical forest carbon to climate is a key uncertainty in predicting global climate change. Although short-term drying and warming are known to affect forests, it is unknown if such effects translate into long-term responses. Here, we analyze 590 permanent plots measured across the tropics to derive the equilibrium climate controls on forest carbon. Maximum temperature is the most important predictor of aboveground biomass (−9.1 megagrams of carbon per hectare per degree Celsius), primarily by reducing woody productivity, and has a greater impact per °C in the hottest forests (>32.2°C). Our results nevertheless reveal greater thermal resilience than observations of short-term variation imply. To realize the long-term climate adaptation potential of tropical forests requires both protecting them and stabilizing Earth’s climate

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701