Gobierno digital en la unidad ejecutora de una entidad constitucionalmente autónoma-Arequipa, 2023

La investigación tuvo como objetivo el analizar el impacto de los avances en la implementación del gobierno digital en la entidad, desde el enfoque de los usuarios de los servicios de la entidad. El enfoque del estudio fue cualitativo optándose por un diseño fenomenológico que permitió alcanzar los objetivos trazados en la investigación, por permitir el dinamismo al momento de hacer la recolección y análisis de los datos. Se tomó como población a personal de la entidad con experiencia e involucrada de las áreas que conforme al criterio de inclusión y forman parte del eje principal de la implementación del GD en la entidad. Como instrumento se utilizó la entrevista semiestructurada sobre el conocimiento y percepción de los entrevistados, se realizó el análisis de los datos obtenidos expresados en la experiencia de los entrevistados, con lo que se culminó alcanzando el objetivo de la presente investigación

Análisis de la limitación de los derechos de libre elección y libre participación en el marco de la ley de paridad y alternancia

La presente investigación titulada “Análisis de la Limitación de los derechos de libre elección y libre participación en el marco de la Ley de Paridad y Alternancia” cuyo objetivo es conocer la existencia y cuáles son esas limitaciones. La metodología aplicada para la investigación es de enfoque cualitativo, su tipo de investigación es básica, el diseño de investigación es bibliográfico, utilizando como instrumento la entrevista, que fue aplicada a siete expertos y entendidos en lo concerniente a la materia del quehacer jurídico, un perito entendido en el comportamiento humano. Del proceso de investigación se concluyó que la Ley de paridad y alternancia, limitan los derechos de libre elección y libre participación, por introducir un requisito de género que contraviene los derechos estipulados en la Constitución Política del Perú, a pesar que la motivación de la ley trata de fomentar mayor participación activa de parte de la mujer, la misma no debería mellar el derecho de libre elección y libre participación

Outcomes of Intra- versus Extra-Corporeal Ileocolic Anastomosis after Minimally Invasive Right Colectomy for Cancer: An Observational Study

Càncer colorectal; Anastomosi extracorpòria; Col·lectomia dreta mínimament invasivaCáncer colorrectal; Anastomosis extracorpórea; Colectomía derecha mínimamente invasivaColorectal cancer; Extracorporeal anastomosis; Minimally invasive right colectomyIntracorporeal anastomoses (IA) are increasingly being used in colorectal surgery. Some data suggest that these might confer benefits compared with extracorporeal anastomoses (EA). The aim of this study is to compare the short-term complications associated with IA versus EA for minimally invasive right colectomy. This is a single-centre, retrospective study on a prospective database. Patients who underwent minimally invasive right colectomy for cancer between January 2017 and December 2019 were assessed for inclusion. The primary outcome was global 30-day morbidity. Overall, 189 patients were included, of whom 102 had IA. Global morbidity and medical complications were higher in patients with EA (23.5% vs. 40.2%, p = 0.014; 5.9% vs. 14.9%, p = 0.039, respectively). None of the patients with IA had non-infectious surgical wound complications, compared to 4.6% in the EA group (p = 0.029). No differences were found in anastomotic leakage (9.8% vs. 10.3%, p = 0.55). At multivariable analysis, EA was an independent risk factor for both surgical (OR = 3.71 95% CI: 1.06–12.91, p = 0.04) and overall complications (OR = 3.58 95% CI: 1.06–12.12, p = 0.04). IA lowers the risk for global, medical, and surgical complications with minimum risk for wound complications, without increasing the risk of ALThis research received no external funding

Cohort profile: the Spanish Early-onset Colorectal Cancer (SECOC) cohort: a multicentre cohort study on the molecular basis of colorectal cancer among young individuals in Spain

Càncer colorectal; Base molecularCáncer colorrectal; Base molecularColorectal cancer; Molecular basisPurpose The Spanish Early-onset Colorectal Cancer (SECOC) study is a multicentre prospective cohort established in Spain to investigate the molecular basis of early-onset colorectal cancer (EOCRC), including metabolic alterations. Participants 220 patients with EOCRC have been enrolled since January 2019 through 18 centres across Spain. Individual-level data were collected by questionnaire, including lifestyle and other colorectal cancer-related factors. Medical record review was performed to capture clinical, histopathological and familial cancer history data. Biospecimen collection (blood, stool, tissue) at diagnosis and at various time points across treatment, as applicable, is also completed. Findings to date Participants had a median age of 44 years (range 14–49), and the majority are men (60%), with individuals age 40–49 years at EOCRC diagnosis being over-represented. Forty-three per cent of participants were diagnosed with a tumour in the rectosigmoid junction/rectum. Nearly two-thirds of EOCRC cases (64%) were diagnosed with advanced stage (III–IV) disease, and 28% of cases had no reported familial history of cancer. Future plans We are actively recruiting and observing participants; we plan to administer follow-up questionnaires and perform additional biospecimen collection. This prospective cohort offers a unique, rich resource for research on EOCRC aetiologies and will contribute to larger international efforts to disentangle the rising disease burden.This work was funded by Projects PI16/01650 and PI20/00974 to JP, from the Spanish Ministry of Health and Consumer Affairs and FEDER. ANH was supported by the National Institutes of Health (NIH) K12 HD043483 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. This work was also supported by the American Cancer Society (#IRG-19-139-59) to ANH

IEEE 1588 High Accuracy Default Profile: Applications and Challenges

Highly accurate synchronization has become a major requirement because of the rise of distributed applications, regulatory requests and position, navigation and timing backup needs. This fact has led to the development of new technologies which fulfill the new requirements in terms of accuracy and dependability. Nevertheless, some of these novel proposals have lacked determinism, robustness, interoperability, deployability, scalability or management tools preventing them to be extensively used in real industrial scenarios. Different segments require accurate timing information over a large number of nodes. Due to the high availability and low price of global satellite-based time references, many critical distributed facilities depend on them. However, the vulnerability to jamming or spoofing represents a well-known threat and back-up systems need to be deployed to mitigate it. The recently approved draft standard IEEE 1588-2019 includes the High Accuracy Default Precision Time Protocol Profile which is intensively based on the White Rabbit protocol. White Rabbit is an extension of current IEEE 1588-2008 network synchronization protocol for sub-nanosecond synchronization. This approach has been validated and intensively used during the last years. This paper revises the pre-standard protocol to expose the challenges that the High Accuracy profile will find after its release and covers existing applications, promising deployments and the technological roadmap, providing hints and an overview of features to be studied. The authors review different issues that have prevented the industrial adoption of White Rabbit in the past and introduce the latest developments that will facilitate the next IEEE 1588 High Accuracy extensive adoption.This work was supported in part by the AMIGA6 under Grant AYA2015-65973-C3-2-R, in part by the AMIGA7 under Grant RTI2018-096228-B-C32, and in part by the Torres Quevedo under Grant PTQ2018-010198

Transcutaneous electrical neuromodulation of the cervical spinal cord depends both on the stimulation intensity and the degree of voluntary activity for training. A pilot study

Electrical enabling motor control (eEmc) through transcutaneous spinal cord stimulation offers promise in improving hand function. However, it is still unknown which stimulus intensity or which muscle force level could be better for this improvement. Nine healthy individuals received the following interventions: (i) eEmc intensities at 80%, 90% and 110% of abductor pollicis brevis motor threshold combined with hand training consisting in 100% handgrip strength; (ii) hand training consisting in 100% and 50% of maximal handgrip strength combined with 90% eEmc intensity. The evaluations included box and blocks test (BBT), maximal voluntary contraction (MVC), F wave persistency, F/M ratio, spinal and cortical motor evoked potentials (MEP), recruitment curves of spinal MEP and cortical MEP and short-interval intracortical inhibition. The results showed that: (i) 90% eEmc intensity increased BBT, MVC, F wave persistency, F/M ratio and cortical MEP recruitment curve; 110% eEmc intensity increased BBT, F wave persistency and cortical MEP and recruitment curve of cortical MEP; (ii) 100% handgrip strength training significantly modulated MVC, F wave persistency, F/M wave and cortical MEP recruitment curve in comparison to 50% handgrip strength. In conclusion, eEmc intensity and muscle strength during training both influence the results for neuromodulation at the cervical level

Tratamiento de la vejiga hiperactiva. Estudio comparativo, experimental, aleatorizado de sulfato de atropina vs dimetilsulfóxido intravesical en 10 dosis intravesicales

Antecedentes: La vejiga hiperactiva tiene un efecto negativo significante sobre la ca-lidad de vida, reflejándose en aislamiento social y depresión. La urgencia urinaria se define como la imperiosa necesidad de micción, un síntoma característico del síndro-me de vejiga hiperactiva, los anti-muscarínicos son la primera línea de tratamiento para los síntomas de urgencia-frecuencia, sin embargo se asocian con efectos adver-sos que limitan su uso. Objetivo: Comparar el resultado de dos tratamientos intravesicales, el sulfato de atro-pina vs. dimetilsulfóxido (DMSO), para evaluar la efectividad en nicturia, capacidad vesical, frecuencia urinaria, urgencia urinaria y escala en calidad de vida en una mues-tra de pacientes con diagnóstico de vejiga hiperactiva. Métodos: Se realizó un estudio experimental longitudinal, prospectivo comparativo, aleatorizado en 14 mujeres con diagnóstico de vejiga hiperactiva comprobada por urodinamia en el Hospital Universitario Dr. José Eleuterio González. Las pacientes fueron divididas en dos grupos. En el grupo 1 (n = 7) se aplicaron 10 dosis intravesicales de 6.0 mg de sulfato de atropina diluidos en 20 mL de solución fisiológica; en el grupo 2 (n = 7) se aplicaron 10 dosis intravesicales de DMSO al 50% (25 mL a 100% diluidos en 25 mL de solución fisiológica). Se registraron como principales variables la frecuencia urinaria, nicturia, urgencia urinaria, capacidad vesical previa y posterior a tratamiento mediante urodinamia. Se evaluaron además con la encuesta de calidad de vida OAB-q en el estado basal y posterior al tratamiento. Resultados: Se observó una disminución en la frecuencia urinaria tanto en el grupo 1 de 9.25 ± 6.5 vs. 5.4 ± 1.1 (p = 0.002), como en el grupo 2 de 10.2 ± 4.42 vs. 6.8 ± 1.8, (p = 0.03). De igual manera, el grado de nicturia mejoró tanto en el grupo 1, 4.5 ± 2.78, y pos-terior al tratamiento de 0.55 ± 0.41 (p = 0.003) y el grupo 2 el nivel basal fue 3.14 ± 1.5

Transcutaneous Electrical Neuromodulation of the Cervical Spinal Cord Depends Both on the Stimulation Intensity and the Degree of Voluntary Activity for Training. A Pilot Study

Electrical enabling motor control (eEmc) through transcutaneous spinal cord stimulation offers promise in improving hand function. However, it is still unknown which stimulus intensity or which muscle force level could be better for this improvement. Nine healthy individuals received the following interventions: (i) eEmc intensities at 80%, 90% and 110% of abductor pollicis brevis motor threshold combined with hand training consisting in 100% handgrip strength; (ii) hand training consisting in 100% and 50% of maximal handgrip strength combined with 90% eEmc intensity. The evaluations included box and blocks test (BBT), maximal voluntary contraction (MVC), F wave persistency, F/M ratio, spinal and cortical motor evoked potentials (MEP), recruitment curves of spinal MEP and cortical MEP and short-interval intracortical inhibition. The results showed that: (i) 90% eEmc intensity increased BBT, MVC, F wave persistency, F/M ratio and cortical MEP recruitment curve; 110% eEmc intensity increased BBT, F wave persistency and cortical MEP and recruitment curve of cortical MEP; (ii) 100% handgrip strength training significantly modulated MVC, F wave persistency, F/M wave and cortical MEP recruitment curve in comparison to 50% handgrip strength. In conclusion, eEmc intensity and muscle strength during training both influence the results for neuromodulation at the cervical level

Multicentric investigation on the safety, feasibility and usability of the ABLE lower-limb robotic exoskeleton for individuals with spinal cord injury : a framework towards the standardisation of clinical evaluations

Robotic lower-limb exoskeletons have the potential to provide additional clinical benefits for persons with spinal cord injury (SCI). However, high variability between protocols does not allow the comparison of study results on safety and feasibility between different exoskeletons. We therefore incorporated key aspects from previous studies into our study protocol and accordingly conducted a multicentre study investigating the safety, feasibility and usability of the ABLE Exoskeleton in clinical settings. In this prospective pretest-posttest quasi-experimental study across two SCI centres in Germany and Spain, in- and outpatients with SCI were recruited into a 12-session training and assessment protocol, utilising the ABLE Exoskeleton. A follow-up visit after 4 weeks was included to assess after-training outcomes. Safety outcomes (device-related adverse events (AEs), number of drop-outs), feasibility and usability measures (level of assistance, donning/doffing-time) were recorded at every session together with changes in gait parameters and function. Patient-reported outcome measures including the rate of perceived exertion (RPE) and the psychosocial impact of the device were performed. Satisfaction with the device was evaluated in both participants and therapists. All 24 participants (45 ± 12 years), with mainly subacute SCI (< 1 year after injury) from C5 to L3, (ASIA Impairment Scale A to D) completed the follow-up. In 242 training sessions, 8 device-related AEs (pain and skin lesions) were reported. Total time for don and doff was 6:50 ± 2:50 min. Improvements in level of assistance and gait parameters (time, steps, distance and speed, p < 0.05) were observed in all participants. Walking function and RPE improved in participants able to complete walking tests with (n = 9) and without (n = 6) the device at study start (p < 0.05). A positive psychosocial impact of the exoskeleton was reported and the satisfaction with the device was good, with best ratings in safety (participants), weight (therapists), durability and dimensions (both). Our study results prove the feasibility of safe gait training with the ABLE Exoskeleton in hospital settings for persons with SCI, with improved clinical outcomes after training. Our study protocol allowed for consistent comparison of the results with other exoskeleton trials and can serve as a future framework towards the standardisation of early clinical evaluations. Trial Registration , DRKS00023503, retrospectively registered on November 18, 2020. The online version contains supplementary material available at 10.1186/s12984-023-01165-0

Micelle-assisted electrodeposition of mesoporous Fe-Pt smooth thin films onto various substrates and their electrocatalytic activity towards hydrogen evolution reaction

Mesoporous Fe-Pt thin films are obtained by micelle-assisted electrodeposition onto metallic substrates with dissimilar activity (namely, gold, copper, and aluminum seed layers evaporated on Si/Ti) under constant applied potential (E=-1.1 V vs. Ag/AgCl) and deposition time (600 s). The amphiphilic triblock copolymer Pluronic P-123 is used as a soft template to guide the formation of mesopores. The occurrence of pores (ca. 7 nm in diameter) with narrow size distribution, distributed evenly over the surface, is observed in all cases. Despite the applied conditions being the same, the roughness and the amount of Fe incorporated in the films are influenced by the nature of the substrate. In particular, ultra-smooth films containing a larger amount of Fe (21 wt %) are obtained when deposition takes place on the Au surface. X-ray diffraction analyses reveal that Pt and Fe are alloyed to a certain extent, although some iron oxides/hydroxides also unavoidably form. The resulting films have been tested as electrocatalysts in the hydrogen evolution reaction (HER) in alkaline media. The mesoporous Fe-rich Fe-Pt films on Au show excellent HER activity and cyclability