Reforma a la sancionabilidad por incumplimiento en el pago del impuesto a la renta de personas naturales y jurídicas.

El ejercicio diario de la profesión de abogado en los diferentes campos, civil, penal, tributario, Aduanero y Rentas, nos ha hecho ver la necesidad de cambiar las estructuras sustantiva y adjetiva en la aplicación de la ley tributaria, en cuanto a procesos y sanciones se refiere. El centro conceptual de la norma, en la nueva estructura jurídica y política que tiene el Ecuador, esto es la Constitución que nos rige desde el 2008, conceptualizada como garantista, nos induce a decir que lo existente en cuanto a principios jurídicos y procesos de reclamo o de orden penal, en el sistema jurídico tributario es en su mayor parte inconstitucional. Sin entrar a analizar los elementos que fueron formando el Derecho Tributario en el país, eso es materia de otro capítulo, debemos expresar la necesidad que existe de definir correctamente el campo y rayar la cancha en la que se opera en la defensa de los derechos de los contribuyentes y de los derechos del estado, sea a título individual o a titulo colectivo, empresas y sociedades. El proceso de administrar justicia tributaria en nuestro país se inicia junto al ordenamiento que crea la nación, pero se sustenta en la normativa positiva vigente en otros países, lo que es lógico, para ir poco a poco delineando una identidad que se acople a nuestra idiosincrasia y costumbres. Cuando irrumpe en el ordenamiento jurídico la nueva constitución, esta nos trae elementos nuevos, propios del derecho consuetudinario aunque mantiene ciertos principios del sistema positivo. El ordenamiento garantista tiene como elemento principal la protección de los derechos fundamentales del ser humano y como característica implementar la sanción penal como una opción de ¿última ratio regum¿ Ultima razón de los reyes. (Cabanellas, Diccionario Enciclopédico de Derecho Usual, 1996) Expresión utilizada para indicar que una acción es considerada como la última acción posible luego de que todas han sido probadas. Partiendo de estas premisas debemos analizar entonces las estructuras procesales contenciosas administrativas y el soporte jurídico procesal penal del derecho tributario

Usefulness of carotid ultrasonography in the diagnosis of coronary artery disease in patients undergoing exercise echocardiography

[Abstract] Background. Relationship between carotid and coronary artery disease (CAD) in patients undergoing invasive and non-invasive test is unclear. The aim of the study is to evaluate whether carotid disease is associated with CAD in patients submitted to exercise echocardiography (EE) and if it improves the EE ability to predict CAD. Methods. We retrospectively studied 156 subjects without previous vascular disease who underwent EE, carotid ultrasonography and coronary angiography between 2002 and 2013. Positive EE was defined as exercise induced wall motion abnormalities, carotid disease according to Manheim and American Society of Echocardiography Consensus and significant CAD as stenosis ≥50%. Results. Eighty-nine (57.1%) subjects had significant CAD. Factors associated with CAD in multivariate analysis were fasting plasma glucose (odds ratio [OR] 1.02, p = 0.031), pre-test probability of CAD > 65% (OR 3.71, p < 0.001), positive EE (OR 10.51, p < 0.001) and carotid plaque (CP) presence (OR 2.95, p = 0.013). There was neither statistical significant difference in area under the curve after addition of CP to EE results (0.77 versus 0.81, p = 0.525) nor sensitivity, specificity, predictive values or efficiency. CP presence reclassified as very high-risk according to Systematic COronary Risk Evaluation 13 patients (34.2%) with negative EE and 22 (33.3%) without CAD. Conclusion. CP is associated with CAD in patients undergoing EE, however its addition to EE does not improve CAD prediction, probably due to insufficient statistical power. CP reclassified one third of patients to very high-risk category despite negative EE or CAD absence, these subjects benefit from aggressive primary prevention interventions.Fundación Ramón Domínguez para la Investigación, el Desarrollo y la Innovación biosanitaria; ECOE

A label-free optical system with a nanohole array biosensor for discriminating live single cancer cells from normal cells

Developing a simple, fast, and label-free method for discrimination between live cancer cells and normal cells in biological samples still remains a challenge. Here, a system is described that fulfills these features to analyze individual living cells. The system consists of a gold nanohole array biosensor plus a microscope optical design to isolate the spectral response of a single cell. It is demonstrated that differences in the spectral behavior between tumor (colorectal cancer cell lines and primary cells from colorectal cancer tissue) and non-tumor cells (peripheral blood mononuclear cells, skin fibroblasts and colon epithelial cells) are influenced by the actin cortex, which lies within the short penetration depth of the surface plasmon electromagnetic field. The efficacy of this system was assessed by the analysis of about one thousand single cells showing the highest discrimination capacity between normal colon epithelial cells and colorectal cancer cells from surgical specimens, with values of sensitivity and specificity ranging 80-100% and 87-100%, respectively. It is also demonstrated that cell discrimination capacity of the system is highly reduced by disrupting the formation of actin cortex. This plasmonic system may find wide applications in biomedicine and to study key cellular processes that involve the actin cortex, including proliferation, differentiation, and migration.This work was supported by the Instituto de Salud Carlos III through grant DTS18/00141, co-funded by European Regional Development Fund/ European Social Fund “A way to make Europe/Investing in your future” and Instituto de Investigación Valdecilla (IDIVAL) (APG/03)

Characterization of Mandibular Border Movements and Mastication in Each Skeletal Class Using 3D Electromagnetic Articulography: A Preliminary Study.

Mandibular movement recording is relevant for the planning and evaluation of mandibular function. These movements can include mandibular border movements (MBM) or mastication. Our objective was to characterize the kinematics of MBM and mastication among skeletal classes I, II, and III in the three spatial planes. A descriptive cross-sectional study was conducted with 30 participants. Instructions were provided on how to form Posselt's envelope and to perform masticatory. After data processing, we obtained numerical values for the areas, trajectories, and ranges of MBM that formed Posselt's envelope and the values for speed, masticatory frequency, and the areas of each masticatory cycle. Significant differences were found in the area of Posselt's envelope in the horizontal plane between skeletal classes I and III and in the range of right laterality between skeletal classes II and III. Mastication showed significant differences in the area of the masticatory cycles in the horizontal plane between classes I and III and between classes II and III. In conclusion, there were differences in MBM and mastication between skeletal classes III and I in the horizontal plane. This study supports the need to establish normal values for mandibular kinematics in skeletal class III

Mortalidad por enfermedad cerebrovascular en el Hospital General Docente “Dr. Agostinho Neto”. Estudio del quinquenio 1993-1997

 Se  realizó  un  estudio tipo caso control  con  el  objetivo  de caracterizar  aspectos de interés relacionados con la  mortalidad por   enfermedad  cerebrovascular  (ECV)  en  el  hospital   "Dr. Agostinho  Neto"  durante  el quinquenio 1993 -  1997.  El  grupo estudio  (fallecidos; n=300) y un grupo control  (vivos;  n=600), ambos  con  diagnóstico de ECV, fueron  seleccionados aleatoriamente  y apareados con una relación 2:1. Los  resultados más  sobresalientes fueron los siguientes: la tasa de  incidencia mostró  una  tendencia  ascendente,  la  ECV  oclusiva  tuvo  una incidencia mayor que la de la ECV hemorrágica. El análisis demostró que  hay una asociación estadísticamente significativa  entre  la ECV y la hipertensión arterial (OR = 830), la edad (OR = 5.78)  y con  el antecedente de ECV previa (OR = 4.33). La  bronconeumonía fue la complicación más frecuente y la causa directa de muerte en el 45.7 % de los fallecidos

Protocol for regional implementation of collaborative self-management services to promote physical activity

Background: Chronic diseases are generating a major health and societal burden worldwide. Healthy lifestyles, including physical activity (PA), have proven efficacy in the prevention and treatment of many chronic conditions. But, so far, national PA surveillance systems, as well as strategies for promotion of PA, have shown low impact. We hypothesize that personalized modular PA services, aligned with healthcare, addressing the needs of a broad spectrum of individual profiles may show cost-effectiveness and sustainability. Methods: The current manuscript describes the protocol for regional implementation of collaborative self-management services to promote PA in Catalonia (7.5 M habitants) during the period 2017-2019. The protocols of three implementation studies encompassing a broad spectrum of individual needs are reported. They have a quasi-experimental design. That is, a non-randomized intervention group is compared to a control group (usual care) using propensity score methods wherein age, gender and population-based health risk assessment are main matching variables. The principal innovations of the PA program are: i) Implementation of well-structured modular interventions promoting PA; ii) Information and communication technologies (ICT) to facilitate patient accessibility, support collaborative management of individual care plans and reduce costs; and iii) Assessment strategies based on the Triple Aim approach during and beyond the program deployment. Discussion: The manuscript reports a precise roadmap for large scale deployment of community-based ICT-supported integrated care services to promote healthy lifestyles with high potential for comparability and transferability to other sites. Trial registration: This study protocol has been registered at ClinicalTrials.org ( NCT02976064 ). Registered November 24th, 2016

Exploring the embryonic development of upper beak in Octopus vulgaris Cuvier, 1797: New findings and implications for age estimation

The beak of cephalopods (in particular octopods, where statoliths are not suitable) is a useful tool for age estimation and the aging method provides essential information on cephalopod growth and life cycles. These parameters are valuable in the assessment of population dynamics and stock management. The embryonic development of cephalopod beaks is poorly known. The presence of pre-hatching increments on the reading areas (rostrum and lateral walls) is unclear and there are no data on temperature influence. In this study, egg clusters of Octopus vulgaris were reared at 16, 19, 21, 23, and 26 °C. The extracted upper jaws were observed in order to validate the age of first daily increment formation, assessing the accuracy of age inferred from the two reading areas. Jaw dimensions were also measured in order to explore the development at different temperature conditions. The growth rate was calculated for beaks of rearing condition 21 °C, and the overall dimensions were compared among all incubation temperatures. Three ad hoc developmental stages are proposed for the upper beak of O. vulgaris embryos. Increments on lateral walls appear during the second phase, whereas the first increment on the rostrum is visible only at hatching. Consequently, only the accuracy of age inferred from the rostrum surface is confirmed for the early stages. The growth rate of the rostrum region accounted for a drop in growth during the third phase. Conversely, the growth rate increased until hatching in lateral walls, suggesting that the heterogeneity of the growth rate could be due to the different role played by the beak areas. Temperature influenced beaks in terms of overall size, as embryos reared at a warm temperature (23 °C) were smaller than the others. These results confirm that the incubation environment could alter hatchling characteristics thus affecting the recruitment conditions.Postprint1,58

Evaluación del control de los pacientes hipertensos dispensarizados de la policlínica "Omar Ranedo Pubillones" de Guantánamo

Se realizó un estudio con los pacientes hipertensos dispensarizados de la Policlínica "Omar Ranedo Pubillones" de Guantánamo, del 1 de abril  de 1997 al 30 de abril de 1998. De la  totalidad de dichos pacientes en el área se obtuvo una muestra sistemática representativa, con el propósito de evaluar el control de la enfermedad en dicha área de salud. Se encontró que el 58,2% de ellos estaban controlados. La edad y el sexo no influyeron en el grado de control de la presión arterial. La patología asociada que se presentó con mayor frecuencia fue la cardiopatía isquémica. El mejor resultado en el control de la enfermedad se obtuvo con el tratamiento combinado farmacológico y no farmacológico. Se concluye que hay un bajo grado de control de la presión arterial en la muestra estudiada