Tendencias tecnológicas en la transformación de la cultura organizacional a través del entendimiento del Cuadro de Mando Integral en una empresa prestadora de servicios públicos de energía

El Cuadro de Mando Integral (CMI) en la organización Centrales Eléctricas del Norte de Santander S.A. E.S.P. se ha utilizado bajo la perspectiva de masificar el acceso y conocimiento de su información a grupos de interés externos e internos, al aprovechar el creciente auge de la transformación digital. Se estudió el contexto actual de los responsables en los niveles directivos, líderes y profesionales P2, en relación a la divulgación, conocimiento, confiabilidad de la información, e implementación de acciones derivadas del CMI mediante una encuesta de percepción; se evaluaron las disyuntivas de las que se desprenden las principales causas de la necesidad abordada y se diseñó un programa de estrategias metodológicas para la transformación cultural. Como la empresa se encuentra en estado de transición en relación a las estrategias encaminadas a la cultura corporativa se sugirió la aplicación de instrumentos digitales gráficos, audiovisuales, influencers y disruptivos a los modos de gestión comunicacional actualmente implementados, en consistencia con el 58% de aceptación obtenido, en conjunto con actividades de socialización cuya información fue validada con un 45% de certeza. Se propuso un programa en el ciclo Deming para el desarrollo de una óptima gestión que tuvieron el propósito de garantizar la articulación y consolidación de fuentes fidedignas de información para la masificación, divulgación, aporte de conocimiento y realimentación a priori de los diversos niveles de la organización, en la que se exalta el lema CMI PARA TODO

It is time to define an organizational model for the prevention and management of infections along the surgical pathway : a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.Peer reviewe

It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants' perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

DISEÑO DE UN BANCO DE HERRAMIENTAS TECNOLOGICAS APLICADO EN LA ACTUALIZACION DE PROCESOS DE FORMACION ACADEMICA EN EL PROGRAMA DE INGENIERIA INDUSTRIAL DE LA UNIVERSIDAD LIBRE SECCIONAL CUCUTA

Proyecto de creación de una banco de herramientas tecnológicas a partir de software libre y gratuito, disponible en la red mundial de información Internet, para actualizar los procesos de formación académica y de enseñanza-aprendizaje de docentes y alumnos del programa de Ingeniería Industrial, mediante su utilización como componente práctico de refuerzo y afianzamiento de fundamentos, principios y formulaciones teóricas impartidas dentro del contenido curricular del mismo

Lesiones pigmentadas de párpado y conjuntiva Pigmented injuries of the eyelid and the conjunctiva

De manera retrospectiva se revisaron las historias clínicas de 141 pacientes con diagnóstico histológico de lesiones pigmentadas, en el período comprendido entre enero de 1989 y diciembre de 1999. El 54 % de los pacientes fueron menores de 20 años. El 57 % eran del sexo femenino. El 57 % de estas lesiones se localizaron en la conjuntiva. El 73,8 % de las lesiones de los párpados eran nevus intradérmicos y en la conjuntiva el 53,8 % correspondieron a nevus compuestos. En nuestra serie encontramos que el grupo de mayor incidencia fue el de pacientes menores de 20 años de edad y el sexo femenino presentó el mayor número de casos. La conjuntiva constituyó la localización anatómica prevaleciente. El nevus intradérmico fue el diagnóstico más frecuente en los párpados y en la conjuntiva predominaron los nevus compuestos.<br>A retrospective review of the medical histories of 141 patients with histological diagnosis of pigmented injuries from January, 1989, to December, 1999, was made. 54 % of the patients were under 20. 57 % were females. 57 % of these injuries were localized in the conjunctiva. 73.8 % of the eyelid injuries were intradermic nevus, whereas in the conjunctiva 53.8% corresponded to compound nevus. We found in our series that the group of patients under 20 had the highest incidence and that females presented a larger number of cases. The conjunctiva was the prevailing anatomical localization. The intradermic nevus was the most frequent diagnosis in the eyelids and the compound nevus predominated in the conjunctiva

Implantes orbitarios de HAP-200: Experiencia en 100 casos Orbital implants of HAP-200: Experience in 100 cases

Exponemos nuestra experiencia en los primeros 100 casos, en los cuales utilizamos implantes orbitarios confeccionados en Cuba con hidroxiapatita porosa coralina (HAP-200), en el período comprendido entre 1995-2000. Nuestra casuística estuvo enmarcada entre los 5 y 65 años de edad, predominando los grupos de edades de 15 a 35 años con 63 casos, el 72 % correspondió al sexo masculino. Los traumatismos primaron como causa de pérdida del globo ocular (80 %). Efectuamos 5 tipos de técnicas quirúrgicas, 22 enucleaciones, 46 evisceraciones (26 con y 9 sin conservación corneal respectivamente, 11 con cuadrisección escleral) y 32 reconstrucciones de cavidades antiguas (implantes secundarios). En la mayoría de los pacientes operados los síntomas y signos posoperatorios fueron locales y catalogados de ligeros, que desaparecieron en la primera semana. Observamos dentro de las complicaciones 12 dehiscencias conjuntivales, 10 exposiciones de los implantes, 2 hipercorrecciones, 1 hipocorrección y 1 quiste conjuntival. La gammagrafía orbitaria demostró crecimiento fibrovascular en la totalidad de los pacientes sometidos a dicha investigación. Los resultados cosméticos evaluados fueron la conservación del surco orbitario y la motilidad del muñón que se consideraron satisfactorios, así como la tolerancia al material implantado que fue buena en el 93 % de los casos al cabo de los 2,5 años.We explain our experience with the first 100 cases in whom orbital implants made in Cuba with coralline porous hydroxyapatite (PHA-200) were placed between 1995 and 2000. Our casuistics comprised patients aged 5-65. It was observed a predominance of the age groups 15-35 with 63 cases. 72 % were males. Traumas prevailed as the main cause of eyeball loss (80 %). 5 types of surgical techniques were performed: 22 enucleations, 46 eviscerations (26 with and 9 without corneal conservation, respectively, 11 with scleral cuadrisection) and 32 reconstructions of old cavities (secondary implants).The postoperative symptoms and signs were local and mild in most of the patients that were operated on and they disappeared during the first week. 12 conjunctival deshicences, 10 implant exposures, 2 hypercorrections, 1 hypocorrection and 1 conjunctival cyst were observed among the complications. The orbital scintigraphy showed fibrovascular growth in all the patients under study. The evaluated cosmetic results were the conservation of the orbital sulcus and the motility of the strump that were considered as satisfactory, as well as the tolerance to the implanted material that was good in 93 % of the cases after 2.5 years

The Calreticulin control of human stress erythropoiesis is impaired by JAK2 V617F in polycythemia vera

Calreticulin (CALR) is a Ca(2+)-binding protein that shuttles among cellular compartments with proteins bound to its N/P domains. The knowledge that activation of the human erythropoietin receptor induces Ca(2+) fluxes prompted us to investigate the role of CALR in human erythropoiesis. As shown by Western blot analysis, erythroblasts generated in vitro from normal sources and JAK2V617F polycythemia vera (PV) patients expressed robust levels of CALR. However, Ca(2+) regulated CALR conformation only in normal cells. Normal erythroblasts expressed mostly the N-terminal domain of CALR (N-CALR) on their cell surface (as shown by flow cytometry) and C-terminal domain (C-CALR) in their cytoplasm (as shown by confocal microscopy) and expression of both epitopes decreased with maturation. In the proerythroblast (proEry) cytoplasm, C-CALR was associated with the glucocorticoid receptor (GR), which initiated the stress response. In these cells, Ca(2+) deprivation and inhibition of nuclear export increased GR nuclear localization while decreasing cytoplasmic detection of C-CALR and C-CALR/GR association and proliferation in response to the GR agonist dexamethasone (Dex). C-CALR/GR association and Dex responsiveness were instead increased by Ca(2+) and erythropoietin. In contrast, JAK2V617F proErys expressed normal cell-surface levels of N-CALR but barely detectable cytoplasmic levels of C-CALR. These cells contained GR mainly in the nucleus and were Dex unresponsive. Ruxolitinib rescued cytoplasmic detection of C-CALR, C-CALR/GR association, and Dex responsiveness in JAK2V617F proErys and its effects were antagonized by nuclear export and Ca(2+) flux inhibitors. These results indicates that Ca(2+)-induced conformational changes of CALR regulate nuclear export of GR in normal erythroblasts and that JAK2V617F deregulates this function in PV