Trascendencia de los cuerpos académicos en beneficio de los programas educativos de una IES

En este trabajo se presenta el resultado obtenido de una investigación en la que se observa el comportamiento de los cuerpos académicos(CA) de una facultad de ingeniería, la cual pretende perfeccionar sus programas educativos(PE) de licenciatura y posgrado a través del trabajo colegiado de sus profesores, el progreso obtenido por estos grupos, los impulsa a fomentar la cultura de la mejora en su misión, propiciando que cada uno de ellos se desarrolle profesionalmente y en conjunto, su sinergía permite promover acciones sustantivas de reconocido valor entre los profesores, lo cual coadyuva en el perfeccionamiento de la cátedra a través de la investigación y el trabajo conjunto. El esfuerzo que realizan los profesores posibilita el desarrollo de habilidades, promueve actitudes positivas hacía el trabajo, cultiva valores trascendentes, lo cual impacta positivamente en el fortalecimiento de la institución educativa. Todo este esfuerzo por promover la importante labor de los cuerpos académicos, beneficia evidentemente a la institución educativa al desarrollar diversas maneras de aplicar conocimiento y aumentar la calidad en función del perfeccionamiento de sus PE, asi mismo a sus profesores que encauzan sus actividades hacía la excelencia académica e indiscutiblemente a sus estudiantes, los cuales enriquecen en forma contundente su formación integral

The Caldera. No. 21

Las huellas que deja el tiempo… Los años siempre dejan su huella… El inexorable paso del tiempo… Son algunas de las expresiones que utilizamos, popularmente, para referirnos a cómo cada almanaque vivido, cómo cada instante que pasa deja sus marcas, sus rastros, sus huellas. En el período Barroco, el hombre cayó en un estado de pesadez existencial, no sólo a nivel económico, político y social, sino que se constituyó en una época que lo sumergió en una crisis existencial; el hombre barroco, descubrió y escribió con horror, sobre la efímera condición de la especie humana. Pero no sólo el hombre del Barroco se ha inquietado con el finito y definitivo paso del hombre por la tierra, también civilizaciones como la Griega, la Romana, la Egipcia, y más cercanas a nosotros, los Incas, los Mayas y los Aztecas, le han rendido culto al paso del tiempo, incluso, crearon sus propias maneras de registrarlo, sus propios calendarios y llevaban un registro de lo que iban viviendo. Yo me atrevo a decir que la dificultad no radica en las marcas físicas que deja el ineludible, el inevitable paso del tiempo; me atrevo a afirmar que el problema es el no dejar huellas positivas, en no dejar ningún rastro loable, ni marca agradable “ninguna estela en el mar”, en palabras de Machado, en nada, ni en nadie.Una obra para la posteridad; Por Matías Gómez Buitrago…06 Dr. Jorge Reynolds Pombo: Orgullo Colombiano; Por Carlos Rodríguez Blanco…10 Ética y moral: Fundamentos de un CALDISTA; Por Andrés David Rojas…14 Nuestra RECTORA; Por Valentina Manrique y Luisa Navarro…18 Líderes Caldistas 2017…24 Lectura: PROCESO FUNDAMENTAL En el Instituto Caldas…36 Instituto CALDAS: 65 AÑOS; Por Carlos Alirio Castillo y Saula Nayibe Figueroa…42 Eventos Conmemoración: 65 años…58 Interclases 2017…62 Nuevos laboratorios…66 Expresiones Caldistas…68 Galería de Imágenes…96 Nuestros MAESTROS…104The traces that time leaves ... The years always leave their mark ... The inexorable passage of time ... These are some of the expressions that we use, popularly, to refer to how each lived almanac, how each passing moment leaves its marks, its traces, her footprints. In the Baroque period, man fell into a state of existential heaviness, not only at the economic, political and social level, but was constituted at a time that plunged him into an existential crisis; the baroque man, discovered and wrote with horror, on the ephemeral condition of the human species. But not only the man of the Baroque has been concerned with the finite and definitive passage of man on earth, also civilizations such as the Greek, the Roman, the Egyptian, and closer to us, the Incas, the Mayas and the Aztecs, They have worshiped the passage of time, even created their own ways of recording it, their own calendars and kept a record of what they were living. I dare say that the difficulty does not lie in the physical marks left by the inescapable, the inevitable passage of time; I dare to affirm that the problem is not to leave positive traces, in not leaving any praiseworthy trace, nor a pleasant mark "no wake in the sea", in the words of Machado, on anything, or on anyone

Management of acute diverticulitis with pericolic free gas (ADIFAS). an international multicenter observational study

Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II-IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4-64, P =0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2-19.9, P =0.023), with 88% of success compared to 96% without free fluid ( P <0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Capitulo 2. Ciencias Naturales y Ciencias Básicas, Ingeniería y Tecnología

La diseminación de la Levitación Magnética, a pesar de lo antiguo de su tecnología, ha sido limitada. Debido a sus inconvenientes prácticos de implementación, su uso es bastante restringido, comparado con otras tecnologías (SCMaglev japonés, Transrapid alemán, o productos comerciales para ocio y entretenimiento). Con el boom de las tecnologías limpias y amigables con el medio ambiente y en concordancia con los objetivos del milenio, es pertinente plantearse el objetivo de optimizar el proceso de Levitación Magnética para generar un aprovechamiento de las ventajas de esta tecnología a nivel mecánico, eléctrico, y ambiental.&nbsp; Actualmente la UNAD adelanta un proyecto de investigación cuyo objetivo es generar un modelo físico matemático de levitación magnética para aplicaciones en ingeniería. De este proyecto se ha derivado una primera revisión sistemática de los principios físicos y los modelos vigentes en Levitación Magnética

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 9

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, volumen 9, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, que cuenta con el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. La gestión del conocimiento es un camino para consolidar una plataforma en las empresas públicas o privadas, entidades educativas, organizaciones no gubernamentales, ya sea generando políticas para todas las jerarquías o un modelo de gestión para la administración, donde es fundamental articular el conocimiento, los trabajadores, directivos, el espacio de trabajo, hacia la creación de ambientes propicios para el desarrollo integral de las instituciones