Metodología para el Desarrollo de los Sistemas de Gestión de la Calidad en PYMES Industriales.

En general, se tiene asumido que los mayores beneficiarios de la implantación de los Sistemas de Gestión de la Calidad (SGC) son sólo las grandes empresas. Sin embargo, las Pequeñas y Medianas Empresas (PYMEs) también pueden favorecerse de las ventajas d

Relaciones paramétricas en el mecanizado

Hace ahora un poco más de dos siglos que J. Wilkinson diseñó una máquina herramienta con la suficiente precisión como para permitir el mecanizado del cilindro y pistón que servirían para la construcción de la máquina de vapor proyectada por Watt. No obstante, muy poco se sabía acerca de los fenómenos implicados en el corte de metales y salvo puntuales trabajos encaminados a esclarecer dichos fenómenos, no es hasta principios de la presente centuria que se aborda de un modo sistemático el estudio científico del mecanizado por herramientas cortantes, de la mano de F. W. Taylor con la publicación de su monumental "On the Art of Cutting Metals". Desde este momento hasta nuestros días, los avances han sido espectaculares, no solamente en la confirmación experimental de los modelos propuestos para el corte, basados en la teoría de la plasticidad, sino en la consecución de nuevos materiales para la fabricación de las herramientas propiamente dichas y en la puesta a punto de tecnologías de alta precisión que han permitido el desarrollo actual de máquinas herramienta con control numérico, capaces de alcanzar cotas muy elevadas de automatización del proceso. Las metas que nos hemos propuesto en este trabajo van encaminadas a presentar una serie de conceptos básicos, con un enfoque que podríamos denominar como clásico. Es decir, pretendemos, y este es uno de nuestros objetivos, consolidar los conocimientos de aquellos lectores que ya poseen una cierta formación práctica en el tema y, también, poner los cimientos para aquellos otros que por vez primera se encuentran frente a las tecnologías de fabricación por arranque de material

La holónica como marco paradigmático para el diseño de interfaces

Inicialmente proponemos los principios que constituyen los sistemas holónicos y cómo estos satisfacen la ley de variedad requerida propuesta por Ashby, para su proyección en la formalización de la ingeniería de la usabilidad, así como para el diseño y desarrollo de interfaces holónicas que satisfagan los principios de autonomía, autoasertividad y cooperación, desde la identificación de su dominio de colaboración y el establecimiento de la competencias que ha de integrar en sus dominios de cooperación.Initially we propose the principles that constitute the holonics system and how these satisfy the law of required variety proposed by Ashby, for its projection in the formalization of the usability engineering, as well as for the design and development of holonic interfaces that satisfy the principles of autonomy, autoasertivity and cooperation, from their identification of collaboration’s domain and the establishment of their competences that it has to integrate in their cooperation’s domain

Modelo holónico de la ingeniería del producto

En el presente trabajo se formula un modelo holónico de la Ingeniería del Producto,soportado por las siguientes entidades holónicas: Estrategia de Producto, Producto, Proceso, Entorno de Diseño y Desarrollo. Dicho modelo se fundamenta desde los principios holónicos propuestos por Koestler y la teoría de la variedad de Ashby. Esta formulación permite dar soporte a: los requerimientos de empresa y producto extendido y virtual, así como al diseño colaborativo y distribuido inteligente.The present work we formulated a holonic model of the Product Engineering, it is supported by the following holonics entities: Product Strategy, Product, Process, Design and Development Context. This model has a foundation from holonics principles proposed by Koestler and the Ashby theory of varieties. This formulation permits giving support to: Company's requests and extended and virtual product, furthermore the collaborative and distributed intelligent

Mutations in Coding and Non-Coding Regions in Varicella-Zoster Virus Causing Fatal Hemorrhagic Fever Without Rash in an Immunocompetent Patient: Case Report

Introduction: We report the case of a fatal hemorrhagic varicella primary infection in an immunocompetent man and whole-genome characterization of the virus for the investigation of biomarkers of virulence. Case: A 38-year-old patient born in Nigeria presented to the emergency department with abdominal pain and subsequently developed fatal hemorrhagic disease without skin rash. Extensive laboratory tests including serology and PCR for arenaviruses, bunyaviruses and ebolaviruses were negative. Varicella-zoster virus (VZV) PCR of sera, liver and spleen tissue samples from autopsy revealed the presence of VZV DNA. Primary infection by varicella-zoster virus with hemorrhagic manifestations was diagnosed after virological testing. The VZV genome was sequenced using a mWGS approach. Bioinformatic analysis showed 53 mutations across the genome, 33 of them producing non-synonymous variants affecting up to 14 genes. Some of them, such as ORF11 and ORF 62, encoded for essential functions related to skin or neurotropism. To our knowledge, the mutations reported here have never been described in a VZV causing such a devastating outcome. Discussion: In immunocompetent patients, viral factors should be considered in patients with uncommon symptoms or severe diseases. Some relevant mutations revealed by using whole genome sequencing (WGS) directly from clinical samples may be involved in this case and deserves further investigation. Conclusion: Differential diagnosis of varicella-zoster virus in immunocompetent adults should be considered among patients with suspected VHF, even if the expected vesicular rash is not present at admission and does not arise thereafter. Whole genome sequencing of strains causing uncommon symptoms and/or mortality is needed for epidemiological surveillance and further characterization of putative markers of virulence. Additionally, this report highlights the recommendation for a VZV vaccination policy in non-immunized migrants from developing countries.This work was supported by a grant from Instituto de Salud Carlos III. Project code MPY1372/12. The journal’s Rapid Service fee was paid by Consorcio Centro de Investigación en Red (CIBER). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

Short-term follow-up of chagasic patients after benznidazole treatment using multiple serological markers

<p>Abstract</p> <p>Background</p> <p>Conventional serological tests, using total soluble proteins or a cocktail of recombinant proteins from <it>T. cruzi </it>as antigens, are highly sensitive for Chagas disease diagnosis. This type of tests, however, does not seem to be reliable tools for short- and medium-term monitoring of the evolution of patients after antiparasitic treatment. The aim of the present study was to search for immunological markers that could be altered in the sera from Chagas disease patients after benznidazole treatment, and therefore have a potential predictive diagnostic value.</p> <p>Methods</p> <p>We analyzed the reactivity of sera from chagasic patients during different clinical phases of the disease against a series of immunodominant antigens, known as KMP11, PFR2, HSP70 and Tgp63. The reactivity of the sera from 46 adult Chronic Chagas disease patients living in a non-endemic country without vector transmission of <it>T. cruzi </it>(15 patients in the indeterminate stage, 16 in the cardiomiopathy stage and 16 in the digestive stage) and 22 control sera from non-infected subjects was analyzed. We also analyzed the response dynamics of sera from those patients who had been treated with benznidazole.</p> <p>Results</p> <p>Regardless of the stage of the sickness, the sera from chagasic patients reacted against KMP11, HSP70, PFR2 and Tgp63 recombinant proteins with statistical significance relative to the reactivity against the same antigens by the sera from healthy donors, patients with autoimmune diseases or patients suffering from tuberculosis, leprosy or malaria. Shortly after benznidazole treatment, a statistically significant decrease in reactivity against KMP11, HSP70 and PFR2 was observed (six or nine month). It was also observed that, following benznidazole treatment, the differential reactivity against these antigens co-relates with the clinical status of the patients.</p> <p>Conclusions</p> <p>The recombinant antigens KMP11, PFR2, Tgp63 and HSP70 are recognized by Chagas disease patients' sera at any clinical stage of the disease. Shortly after benznidazole treatment, a drop in reactivity against three of these antigens is produced in an antigen-specific manner. Most likely, analysis of the reactivity against these recombinant antigens may be useful for monitoring the effectiveness of benznidazole treatment.</p

Differences in clinical features and mortality in very old unvaccinated patients (≥ 80 years) hospitalized with COVID-19 during the first and successive waves from the multicenter SEMI-COVID-19 Registry (Spain)

Background: Old age is one of the most important risk factors for severe COVID-19. Few studies have analyzed changes in the clinical characteristics and prognosis of COVID-19 among older adults before the availability of vaccines. This work analyzes differences in clinical features and mortality in unvaccinated very old adults during the first and successive COVID-19 waves in Spain. Methods This nationwide, multicenter, retrospective cohort study analyzes unvaccinated patients >= 80 years hospitalized for COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry). Patients were classified according to whether they were admitted in the first wave (March 1-June 30, 2020) or successive waves (July 1-December 31, 2020). The endpoint was all-cause in-hospital mortality, expressed as the case fatality rate (CFR). Results Of the 21,461 patients hospitalized with COVID-19, 5,953 (27.7%) were >= 80 years (mean age [IQR]: 85.6 [82.3-89.2] years). Of them, 4,545 (76.3%) were admitted during the first wave and 1,408 (23.7%) during successive waves. Patients hospitalized in successive waves were older, had a greater Charlson Comorbidity Index and dependency, less cough and fever, and met fewer severity criteria at admission (qSOFA index, PO2/FiO2 ratio, inflammatory parameters). Significant differences were observed in treatments used in the first (greater use of antimalarials, lopinavir, and macrolides) and successive waves (greater use of corticosteroids, tocilizumab and remdesivir). In-hospital complications, especially acute respiratory distress syndrome and pneumonia, were less frequent in patients hospitalized in successive waves, except for heart failure. The CFR was significantly higher in the first wave (44.1% vs. 33.3%; -10.8%; p = 95 years (54.4% vs. 38.5%; -15.9%; p < 0.001). After adjustments to the model, the probability of death was 33% lower in successive waves (OR: 0.67; 95% CI: 0.57-0.79). Conclusions Mortality declined significantly between the first and successive waves in very old unvaccinated patients hospitalized with COVID-19 in Spain. This decline could be explained by a greater availability of hospital resources and more effective treatments as the pandemic progressed, although other factors such as changes in SARS-CoV-2 virulence cannot be ruled out

Diseño de entornos de enseñanza-aprendizaje de ingeniería gráfica mediante estructuras integradas en contextos colaborativos

En este trabajo se realiza una aproximación a las últimas tendencias organizacionales para identificar las capacidadesde ingeniería gráfica y de diseño en estos nuevos contextos. En concreto, se ha tomado un sistema holónico con estructura fractal. Se han analizado aquellas capacidades que aparecen en cada nivel de estos modelos de organización. De igual forma, se han estudiado las conxiones e interacciones entre cada uno de los holones analizados. Asimismo , se ha contemplado la posibilidad de trasladar la estructura desarrollada a un contexto de enseñanza-aprendizaje. En particular, se ha elaborado un modelo para el sistema de enseñanza-aprendizaje de la Ingeniería Gráfica basado en consideraciones holónicas.In this work, an approximation to the last organisational trends have been made in order to identify of Grafic and Design Engineering. As starting point, a Fractally-Stuctured Holonic System has been use as organisational model. The capabilities included in each level of these models have been analysed. Furthermore, the connections and interactions among evrery holons identified has been included. In the same way, the structure developed has been traslated to a learning-teaching context. Particularly, a holonic concepts based concepts based model has been developed for the Grafic Engineerin Learning System

Spontaneous retroperitoneal hematoma in a patient under anticoagulant agents presenting as upper gastrointestinal bleeding

We present the case of a 44-year-old woman with past history of repeated miscarriage and Budd-Chiari syndrome secondary to primary myelofibrosis. Because of this she was under treatment with oral anticoagulant agents. The patient was admitted in hospital as she presented with gastrointestinal bleeding (melena), asthenia and progressive anemia. In an initial upper endoscopy an extrinsic duodenal compression associated with an ulcer on the posterior face of the first portion of duodenum and upper duodenal knee was observed. In the following days a huge spontaneous retroperitoneal hematoma due to anticoagulation was diagnosed by computed tomography. This was treated with a percutaneous drainage and withdrawal of the antithrombotic drugs. The evolution of the patient was initially satisfactory but she suffered subclavian and jugular vein thrombosis, and reintroduction of anticoagulant agents at the lowest therapeutic doses was required