7 research outputs found

    Libro del XVIII Congreso Nacional de Ciencia y Tecnología - APANAC 2021

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    Desde su fundaci√≥n en 1985, APANAC ha sido clave en promover un espacio de comunicaci√≥n y crecimiento para la comunidad cient√≠fica en Panam√°, a trav√©s de la promoci√≥n de sus logros, as√≠ como en la promoci√≥n ante el Estado de la necesidad de apoyar el desarrollo de la Ciencia como base para el crecimiento sostenible de nuestra sociedad. As√≠ es como hace cerca de 25 a√Īos, APANAC juega un papel fundamental en la generaci√≥n y promulgaci√≥n de la Ley 13 de 1997 con la que se crea SENACYT. Igualmente, dentro de esta misi√≥n de desarrollo a la comunidad cient√≠fica se ha logrado consolidar el Congreso que hoy se inaugura en su XVIII versi√≥n. Este Congreso en particular ha representado un reto muy importante, sobretodo por darse en medio de una pandemia global, con devastadoras consecuencias econ√≥micas, que ha puesto de manifiesto las profundas diferencias que aquejan a la sociedad paname√Īa. Sin embargo, estas circunstancias, han hecho tambi√©n evidente la importancia de la Ciencia y la Tecnolog√≠a, reforzando la necesidad de que las pol√≠ticas p√ļblicas, planes de Gobierno o bien las respuestas a las crisis, se hagan no s√≥lo con base en evidencias cient√≠ficas, sino tambi√©n con una perspectiva interdisciplinaria. Es as√≠ como este Congreso tiene una relevancia √ļnica, dado que muestra la existencia en nuestro pa√≠s de una masa cr√≠tica de cient√≠ficos y acad√©micos comprometidos en sus diferentes √°reas de trabajo con el desarrollo de Panam√°. La calidad de las conferencias, mesas redondas y simposios que se presentan en este XVIII Congreso es muestra de ello, sobretodo porque en su gran mayor√≠a, son el producto de trabajos nacionales. Agradecemos a la SENACYT, as√≠ como a todas las Universidades e Institutos de Investigaci√≥n Nacional por su apoyo y activa participaci√≥n en este Congreso, a la Ciudad del Saber por su soporte log√≠stico y a la Embajada del Estado de Israel en Panam√° por su gesti√≥n en facilitar la participaci√≥n de muchos de los prestigiosos expositores invitados

    Análisis de los perfiles de investigadores de Panamá e indicadores bibliométricos de Google Scholar

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    The objective of this article is to evaluate the visibility of researchers in Panama and the impact of their publications using bibliometric indicators including h-index, i10index and profile citations in Google Scholar Citations (GSC) categorized by gender, institution, and SNI membership. For automatic data collection in GSC we created an algorithm in the R language which extracted 860 profiles from 47 institutions. 25.5% of the profiles had no citation accounting, and 29.5% had an h-index over 5. Of the 14530 studies extracted from the profiles, 49.3% have been cited once, generating 287616 citations. 62% of citations are from studies by 28 researchers. There is visibility for Panamanian researchers in GSC, but only 3.3% provide 62% of citations, with little impact in publications and indexing errors. This suggests a need to create institutional policies to normalize profile creation.El objetivo de este artículo es evaluar la visibilidad de los investigadores de Panamá y el impacto de sus publicaciones utilizando indicadores bibliométricos como h-index, i10-index y citas de los perfiles en Google Scholar Citations (GSC) categorizados por sexo, institución, miembro del SNI. Para la recolección automática de datos en GSC se creó un algoritmo en el lenguaje R que extrajo 860 perfiles de 47 instituciones, el 25,5% de los perfiles no se contabilizaron citas, el 29,5% tiene un h-index mayor a 5. De los 14.530 trabajos extraídos de los perfiles, 49,3% ha sido citado una vez generando 287.616 citas, 62% de las citas son de trabajos de 28 investigadores. Existe visibilidad de los investigadores de Panamá en GSC, pero solo el 3,3% aporta el 62% de las citas, poco impacto en las publicaciones y errores de indexación, esto sugiere crear políticas institucionales para normalizar la creación de los perfiles

    Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

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    Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung‚Äôs disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung‚Äôs disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58¬∑0%) were male. Median gestational age at birth was 38 weeks (IQR 36‚Äď39) and median bodyweight at presentation was 2¬∑8 kg (2¬∑3‚Äď3¬∑3). Mortality among all patients was 37 (39¬∑8%) of 93 in low-income countries, 583 (20¬∑4%) of 2860 in middle-income countries, and 50 (5¬∑6%) of 896 in high-income countries (p<0¬∑0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90¬∑0%] of ten in lowincome countries, 97 [31¬∑9%] of 304 in middle-income countries, and two [1¬∑4%] of 139 in high-income countries; p‚ȧ0¬∑0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2¬∑78 [95% CI 1¬∑88‚Äď4¬∑11], p<0¬∑0001; middle-income vs high-income countries, 2¬∑11 [1¬∑59‚Äď2¬∑79], p<0¬∑0001), sepsis at presentation (1¬∑20 [1¬∑04‚Äď1¬∑40], p=0¬∑016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4‚Äď5 vs ASA 1‚Äď2, 1¬∑82 [1¬∑40‚Äď2¬∑35], p<0¬∑0001; ASA 3 vs ASA 1‚Äď2, 1¬∑58, [1¬∑30‚Äď1¬∑92], p<0¬∑0001]), surgical safety checklist not used (1¬∑39 [1¬∑02‚Äď1¬∑90], p=0¬∑035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1¬∑96, [1¬∑41‚Äď2¬∑71], p=0¬∑0001; parenteral nutrition 1¬∑35, [1¬∑05‚Äď1¬∑74], p=0¬∑018). Administration of parenteral nutrition (0¬∑61, [0¬∑47‚Äď0¬∑79], p=0¬∑0002) and use of a peripherally inserted central catheter (0¬∑65 [0¬∑50‚Äď0¬∑86], p=0¬∑0024) or percutaneous central line (0¬∑69 [0¬∑48‚Äď1¬∑00], p=0¬∑049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

    Visibilidad de los Repositorios institucionales de acceso abierto en Panam√° integrados en OpenDoar y el repositorio Nacional PRICILA

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    El acceso abierto tiene como objetivo garantizar un acceso inmediato, sin restricciones tecnol√≥gicas o legales, a la producci√≥n acad√©mica y cient√≠fica de una instituci√≥n, siendo una de las estrategias m√°s utilizadas para mostrar recursos generados en abierto mediante la implementaci√≥n de repositorios institucionales. Los repositorios son plataformas digitales dise√Īadas para centralizar, capturar y preservar recursos generados por acad√©micos en actividades de ense√Īanza, aprendizaje e investigaci√≥n, facilitando el acceso al conocimiento. Esto se alinea con el Objetivo de Desarrollo Sostenible relacionado con garantizar una educaci√≥n inclusiva, equitativa y de calidad, y promover oportunidades de aprendizaje para todos. La visibilidad mejora la difusi√≥n y ampl√≠a el impacto del trabajo acad√©mico e investigativo almacenado en los repositorios, aunque estos deben cumplir con diversos criterios establecidos en la gu√≠a para la evaluaci√≥n de repositorios institucionales creada por Recolecta, el agregador europeo de repositorios.El objetivo fue evaluar la visibilidad, interoperabilidad y pol√≠ticas de acceso abierto de repositorios institucionales en Panam√°. El estudio combin√≥ t√©cnicas cuantitativas y cualitativas para recopilar datos de nueve plataformas que integran repositorios, incluido el directorio OpenDoar, durante enero de 2022 a marzo de 2023.Se identificaron 37 repositorios centroamericanos, con 5 de Panam√°, aunque el repositorio nacional registr√≥ 9. El 65% de los repositorios centroamericanos usaban Dspace, mientras que en Panam√° fue del 88.9%. Todos los repositorios paname√Īos ten√≠an el protocolo OAI-PMH para interoperabilidad, aunque tres no eran accesibles, y solo uno mostraba la URL del OAI-PMH para recolecci√≥n.El promedio de documentos en repositorios paname√Īos fue de 134, indexados en Google Scholar, comparado con 1095 en Centroam√©rica. En cuanto a visibilidad e integraci√≥n en otras plataformas, repositorios paname√Īos estaban en Google Scholar (6), CORE (6), BASE (4), OpenAire (2), ROAR (2), DuraSpace (2), RepoCentroAmericano (3) y Repo Nacional PRICILA (9), con solo un repositorio integrado en todas las plataformas. Solo tres repositorios ten√≠an pol√≠ticas de acceso abierto. Se concluye que son necesarias estrategias para integrar repositorios en plataformas digitales para mejorar la visibilidad. Se recomienda verificar la generaci√≥n autom√°tica de metadatos mediante OAI-PMH para una recolecci√≥n adecuada de documentos. Desarrollar pol√≠ticas de acceso abierto es crucial para reconocer la importancia de estas plataformas en el ecosistema de la ciencia abierta y aumentar la visibilidad. &nbsp

    Medical decisions concerning the end of life for cancer patients in three Colombian hospitals ‚Äď a survey study

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    Background: Cancer patients’ end-of-life care may involve complex decision-making processes. Colombia has legislation regarding provision of and access to palliative care and is the only Latin American country with regulation regarding euthanasia. We describe medical end-of-life decision-making practices among cancer patients in three Colombian hospitals. Methods: Cancer patients who were at the end-of-life and attended in participating hospitals were identified. When these patients deceased, their attending physician was invited to participate. Attending physicians of 261 cancer patients (out of 348 identified) accepted the invitation and answered a questionnaire regarding end-of-life decisions: a.) decisions regarding the withdrawal or withholding of potentially life-prolonging medical treatments, b.) intensifying measures to alleviate pain or other symptoms with hastening of death as a potential side effect, and c.) the administration, supply or prescription of drugs with an explicit intention to hasten death. For each question addressing the first two decision types, we asked if the decision was fully or partially made with the intention or consideration that it may hasten the patient’s death. Results: Decisions to withdraw potentially life-prolonging treatment were made for 112 (43%) patients, 16 of them (14%) with an intention to hasten death. For 198 patients (76%) there had been some decision to not initiate potentially life-prolonging treatment. Twenty-three percent of patients received palliative sedation, 97% of all patients received opioids. Six patients (2%) explicitly requested to actively hasten their death, for two of them their wish was fulfilled. In another six patients, medications were used with the explicit intention to hasten death without their explicit request. In 44% (n = 114) of all cases, physicians did not know if their patient had any advance care directives, 26% (n = 38) of physicians had spoken to the patient regarding the possibility of certain treatment decisions to hasten death where this applied. Conclusions: Decisions concerning the end of life were common for patients with cancer in three Colombian hospitals, including euthanasia and palliative sedation. Physicians and patients often fail to communicate about advance care directives and potentially life-shortening effects of treatment decisions. Specific end-of-life procedures, patients’ wishes, and availability of palliative care should be further investigated.</p

    Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

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    Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p&lt;0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p&lt;0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status

    Notes for genera ‚Äď Ascomycota