Applying the clustering technique for characterising maintenance outsourcing

Objetivo Utilizar técnicas de clustering para caracterizar a los proveedores de servicios de mantenimiento de una institución de salud. Métodos El estudio analiza el inventario del equipamiento perteneciente a 7 áreas pilotos (264 equipos médicos). Se aplican técnicas de clustering usando 26 variables. Entre las más significativas: el tiempo de respuesta (RT), la duración de las intervenciones (DR), la disponibilidad y el tiempo de cambio de estado (TAT). Resultados La obsolescencia del equipo biomédico en promedio es de 0,78. Se identifican 4 grupos de proveedores de servicios. Grupos (1 y 3): Mejor desempeño, menores valores de TAT, RT y DR; cuyos proveedores son: O, L, C, B, I, S, H, F, G; representan el 56 % del total; con valores de TAT entre: 1,4 días <TAT < 2,56 días como promedio. Grupo (0): Desempeño medio, cuyos proveedores son: V, M, K, Z, T, Y; representan el 38 %; con valores de TAT iguales a 9,79 días como promedio. Grupo (2): con bajos desempeños, por poseer valores altos de TAT (101 días como promedio); con único proveedor: J, representa el 6 % del total de la muestra analizada. Conclusiones La metodología empleada permitió caracterizar el inventario de equipos médicos y a los proveedores de servicios de mantenimiento. La técnica de conglomerados demostró ser efectiva para identificar los proveedores más competitivos. Palabras Clave: Disponibilidad de servicios de salud, servicios contratados, análisis por conglomerados, servicio de mantenimiento e ingeniería en hospital, ingeniería biomédicaUsing clustering techniques for characterising companies providing health institutions with maintenance services.METHODS: The study analysed seven pilot areas' equipment inventory (264 medical devices). Clustering techniques were applied using 26 variables. Response time (RT), operation duration (OD), availability and turnaround time (TAT) were amongst the most significant ones.RESULTS: Average biomedical equipment obsolescence value was 0.78. Four service provider clusters were identified: clusters 1 and 3 had better performance, lower TAT, RT and DR values (56 % of the providers coded O, L, C, B, I, S, H, F and G, had 1 to 4 day TAT values: <TAT < 2.56 days on average). Cluster 0 had medium performance (38 % of providers coded V, M, K, Z, T and Y, having an average 9.79 TAT value). Cluster 2 (6 % - provider J) had low performance, having very a high TAT level (101 days on average).CONCLUSIONS: The methodology allowed medical equipment inventory and maintenance service suppliers to be characterised. The cluster technique was effective in identifying the most competitive suppliers

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Dementia in Latin America : paving the way towards a regional action plan

Regional challenges faced by Latin American and Caribbean countries (LACs) to fight dementia, such as heterogeneity, diversity, political instabilities, and socioeconomic disparities, can be addressed more effectively grounded in a collaborative setting based on the open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking and translational research) and align them to current global strategies to translate regional knowledge into actions with transformative power. Then, by characterizing genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions and mapping these to the above challenges, we provide the basic mosaics of knowledge that will pave the way towards a KtAF. We describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Applying the clustering technique for characterising maintenance outsourcing

Objetivo Utilizar técnicas de clustering para caracterizar a los proveedores de servicios de mantenimiento de una institución de salud. Métodos El estudio analiza el inventario del equipamiento perteneciente a 7 áreas pilotos (264 equipos médicos). Se aplican técnicas de clustering usando 26 variables. Entre las más significativas: el tiempo de respuesta (RT), la duración de las intervenciones (DR), la disponibilidad y el tiempo de cambio de estado (TAT). Resultados La obsolescencia del equipo biomédico en promedio es de 0,78. Se identifican 4 grupos de proveedores de servicios. Grupos (1 y 3): Mejor desempeño, menores valores de TAT, RT y DR; cuyos proveedores son: O, L, C, B, I, S, H, F, G; representan el 56 % del total; con valores de TAT entre: 1,4 días <TAT < 2,56 días como promedio. Grupo (0): Desempeño medio, cuyos proveedores son: V, M, K, Z, T, Y; representan el 38 %; con valores de TAT iguales a 9,79 días como promedio. Grupo (2): con bajos desempeños, por poseer valores altos de TAT (101 días como promedio); con único proveedor: J, representa el 6 % del total de la muestra analizada. Conclusiones La metodología empleada permitió caracterizar el inventario de equipos médicos y a los proveedores de servicios de mantenimiento. La técnica de conglomerados demostró ser efectiva para identificar los proveedores más competitivos. Palabras Clave: Disponibilidad de servicios de salud, servicios contratados, análisis por conglomerados, servicio de mantenimiento e ingeniería en hospital, ingeniería biomédicaUsing clustering techniques for characterising companies providing health institutions with maintenance services.METHODS: The study analysed seven pilot areas' equipment inventory (264 medical devices). Clustering techniques were applied using 26 variables. Response time (RT), operation duration (OD), availability and turnaround time (TAT) were amongst the most significant ones.RESULTS: Average biomedical equipment obsolescence value was 0.78. Four service provider clusters were identified: clusters 1 and 3 had better performance, lower TAT, RT and DR values (56 % of the providers coded O, L, C, B, I, S, H, F and G, had 1 to 4 day TAT values: <TAT < 2.56 days on average). Cluster 0 had medium performance (38 % of providers coded V, M, K, Z, T and Y, having an average 9.79 TAT value). Cluster 2 (6 % - provider J) had low performance, having very a high TAT level (101 days on average).CONCLUSIONS: The methodology allowed medical equipment inventory and maintenance service suppliers to be characterised. The cluster technique was effective in identifying the most competitive suppliers

Comentarios a visión Colombia II centenario: 2019

With the purpose of contributing to the academic debate about how Colombia should be in the year 2019, EAFIT University, through its Political Sciences, Law and Economics programs, presents a theoretical and critical analysis of the book “Visión Colombia II Centenario: 2019”.The documents presented elaborate four fundamental aspects developed in the book: A society of free and responsible citizens; an efficient state at the service of its citizens; an economy that guarantees a higher level of welfare and a more egalitarian and compromised society. Critical reflection is the common base for these documents that intend to make an invitation to the academia for an open debate that contributes to the elaboration of a broader and pluralist proposal towards the construction of a better Colombia by the year 2019.En este documento, con el propósito de contribuir al debate académico en torno a cómo debería ser Colombia en el 2019, la Universidad EAFIT, en cabeza de las carreras de Ciencias Políticas, Derecho y Economía presenta los análisis teóricos y críticos al libro Visión Colombia II Centenario: 2019.Los documentos que se presentan versan sobre cuatro aspectos fundamentales del libro: Una sociedad de ciudadanos libres y responsables; un Estado eficiente al servicio de los ciudadanos; Una economía que garantice mayor nivel de bienestar y una sociedad más igualitaria y solidaria. La reflexión crítica, es el común denominador de estos, y su intencionalidad se inscribe en el llamado al debate amplio que se hace a la academia de contribuir en la construcción de una propuesta amplia, plural y con argumentos que conduzca a una mejor Colombia hacia el 2019

Inmunología de la reacción del citomegalovirus en trasplante renal

IP 1115-05-068-86Vol. 11, no 4 (oct-dic 1990); p. 1-6. -- PONENCIA(S) EN CONGRESO: Histocompatibilidad, citomegalovirus y;transplante renal / Jorge E. Ossa. ... [et. al]. -- En: CongresoColombiano de Medicina Interna (11 1990 oct :;11-15 : Cali, Colombia). -- Cali, 1990. -- p. -- 28 cm.;ARTICULO(S) EN REVISTA: Inmunobiologia de la infeccion porcitomegalovirus/ Jorge E. Ossa. -- En: Acta;Medica Colombiana. -- Vol. 12, no. 3 (may-jun 1987); p. 25462041.'-- Prevalencia de infeccion por;citomegalovirus / Jorge E. Ossa. ... [et. al]. -- En: ActaMedica Colombiana. -- Vol. 13, no. 3 (may-jun;1988); p. 125-128. -- Inmunopatogenesis de la infeccion por citomegalovirus en inmunosuprimidos pacientes /;Jorge E. Ossa. -- En: Temas Microbiologicos. -- Vol 10, no. 4(1989); p. 3-5. -- Frecuencia de Infeccion por;herpesvirus en 129 niños en edad escolar en Antioquia / JorgeE.Ossa. ...[etal]. -- En: Revista Medica;Universidad de Antioquia. -- Vol. 3, no 1. (mar 1990); p.413309.'-- Estandarizacion de un metodo de ELISA para;citomegalovirus humano / Jorge E. Ossa. ... [et al]. -- En: Revista de laActa Medica Colombiana. -- Vol. 15,;no. 4 (jul-ago 1990); p. 180-186. -- Prevalencia de infeccionpor citomegalovirus en receptores y donantes de;trasplante renal en Medellin para 1988-1989 / Jorge E. Ossa. ...[et. al].'-- en: Revista de La Acta Medica;Colombiana. -- Vol. 15, no. 4 (jul-ago 1990); p. 175-179.'-- Inmunobiologia del transplante renal historia de;los transplantes y del complejo mayor de histocompatibilidad /Jorge E. Ossa, Martin Correa. -- En: Revista;Medica Universidad de Antioquia. -- Vol. 3, no 2. (jul 1990);p.97-104. -'- aislamiento y tipificacion de;adenovirus tipo 3 en un caso de bronconeumonia / Jorge E.Ossa.... [et. al]. -- En: Temas Microbiologicos. -