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Introduction: Diode laser cyclophotocoagulation constitutes a treatment alternative to increase the quality of life in patients with blind and painful eyes with absolute glaucoma. Materials and Methods: A retrospective comparative study was carried out in patients with absolute glaucoma of any etiology with the aim of comparing the effectiveness and safety of MicroPulse transscleral laser therapy (MP-TLT) versus continuous wave transscleral cyclophotocoagulation in eyes of patients with absolute glaucoma. A total of 104 eyes were studied and two groups were formed: 52 treated with CW and 52 eyes treated with MP. Baseline characteristics (number, proportions, mean, and standard deviation) were summarized and compared between the two groups using the Chi-square test. Results: Mean pain was 4.5 out of 10 for the group treated with CW and 5.75 for the group treated with MP. In the CW group, the success rate was 75.0% (P = 0.001); for MP, it was 70.8% (P = 0.002). A decrease in the number of topical antiglaucomatous drugs used was found for the CW group, from a mean of 2.9 eye drops ± 1 at the beginning of the study to 1.9 ± 1.2 at two years of investigation and MP from 3.1 ± 0.5 to 2.1 ± 0.5) and with acetazolamide (P = 0.001 and 0.002), respectively. Significant complications were in the CW group (hypotony in 3, 5.7% eyes, bulbar phthisis in 1, 1.9% eye, and corneal perforation 2, 3.8% eyes; P = 0.03). Conclusions: Both techniques reduced the painful component, being more stable over time with the use of continuous wave transscleral cyclophotocoagulation (CW-TSCP), which showed greater long-term intraocular pressure control, and a higher success rate, but with a significantly lower safety profile due to the number of complications presented. The number of topical antiglaucomatous drugs and acetazolamide was decreased with both procedures.

La pandemia del COVID-19 ha puesto en evidencia el grave problema de la falta de colaboración entre las entidades y los contratistas en la ejecución de los contratos con el Estado. Ante situaciones imprevisibles y la necesidad de toma de decisiones ágiles para mitigar o disminuir los impactos de la pandemia, en muchos casos las partes mantuvieron una conducta conflictiva antes que una colaborativa que priorice la buena gestión contractual para alcanzar la finalidad de la contratación, lo cual puso en riesgo la atención de necesidades para atender la emergencia sanitaria, el dinamismo de la economía, la generación de puestos de trabajo, la inversión en gasto público, entre otros fines. Por ello, es importante conocer las herramientas de colaboración en contratación pública que están disponibles en la normativa vigente, así como aquellas que pueden ser implementadas, sin perder de vista que fomentar la confianza entre los actores del sistema de contratación pública resulta esencial para alinear los intereses de las partes y generar una efectiva gestión colaborativa. En el presente artículo se analizarán principales conceptos sobre la colaboración entre las partes y la forma en que diferentes herramientas pueden fomentar esta colaboración.

Este artículo muestra la importancia de la MML y la aplicación que de esta metodología realizan los semilleros de investigación en la zona centro sur -ZCSUR de una Universidad a distancia. La investigación realiza el inventario de todos los semilleros de la Universidad en la zona, determina cada uno de los aspectos teóricos de la MML e indaga por medio de una encuesta realizada a los 30 semilleros de la zona Centro Sur, sobre diferentes metodología y técnicas que guían el trabajo del semillero, tomando como referente la matriz de marco lógico (MML). Se encontró que es deficiente el desempeño de los semilleros en la utilización de metodologías como la MML y se realiza un comparativo entre lo que se hace o lo que debe hacerse resaltando las ventajas que trae la aplicación de la metodología para el incremento en la producción y efectividad de los semilleros de investigación.

The Webquest is a type of didactic activity based on constructivist assumptions of the teaching - learning process. This research, in the context of innovation, proposes a didactic experience for three groups of teachers, to design, develop and implement webquest for the teaching of science. It is guided by a guided indagatory methodology that promotes meaningful learning and improves academic performance. The methodological teaching proposal is theoretically based on the significant learning of Ausubel, on cognitive developments of Piaget, zone of proximal development of Vygotsky and the cooperative work of Jonhson and Jonhson. The research is experimental, essentially quantitative, with an exploratory, descriptive study. The results ensure an important advance between the pretest and posttest of each work group, with a tangible product that can be used in the science classrooms.

We investigate the diffusion of conspiracy theories related to the origin of COVID-19 on social media. By analyzing third-party content on four social media platforms, we show that: (a) In contrast to conventional wisdom, mainstream sources contribute overall more to conspiracy theories diffusion than alternative and other sources; and (b) platforms’ content moderation practices are able to mitigate the spread of conspiracy theories. Nevertheless, we locate issues regarding the timeliness and magnitude of content moderation, as well as that platforms filter significantly fewer conspiracy theories coming from mainstream sources. Given this, we discuss policy steps that can contribute to the containment of conspiracy theories by media sources, platform owners, and users.

Resumen Introducción: Los modelos de atenci.n m.dica en el mundo reflejan la relaci.n entre los distintos actores del sistema de salud y de las personas que viven en el territorio, basada en relaciones de confianza y ayuda, cuyo objetivo es lograr el bienestar biopsicosocial de las personas, familias y comunidades, lo que implica una visi.n hol.stica del cuidado de la salud. En el Segundo Hospital de la provincia de Anhui en China, se implement. un modelo de atenci.n oftalmol.gica en las comunidades rurales de forma gratuita y accesible con el diagn.stico oportuno y el tratamiento m.dico quir.rgico personalizado para elevar la calidad de la atenci.n oftalmol.gica. Método: Se aplic. un modelo de atenci.n oftalmol.gica clinico- quir.rgico en cuatro comunidades rurales de la provincia de Anhui (Huainan, Wuhu, Xuancheng y Luan) desde el a.o 2013 hasta 2017. Las afecciones oculares encontradas en los distintos distritos visitados fueran trastornos refractivos, catarata senil, miop.a, retinopatia diab.tica, pterigion, estrabismo no quir.rgico y obstrucci.n de v.as lagrimales. Se disponia de un carro m.vil equipado con alta tecnolog.a y que cumplia con los requerimientos para procedimientos cl.nicos y quir.rgicos. El equipo de oftalmolog.a estuvo integrado por 6 miembros (4 m.dicos, 1 Licenciado en .ptica y optometr.a y un ingeniero en Electromedicina). Se estableci. coordinaci.n con el Consejo de Direcci.n de nuestro hospital, el Departamento de Trabajo y Seguridad Social, con los gobiernos locales y centros de salud de los lugares a visitar. Resultados: Del total de pacientes vistos en consulta (7075), el 57.3 % correspond.a al sexo masculino, con edades de 60 a.os y m.s. Los pacientes con diagn.stico de catarata senil representavan el 28,7%, con 2031 casos vistos; de ellos, 1754 tuvieron soluci.n quir.rgica (81.4%). El ojo izquierdo fue el m.s operado y la LIO implantada fue la plegable. Se reportaron m.nimas complicaciones como la ruptura de la c.psula posterior y endotelitis, las m.s frecuentes que no superaran el 1%. Los pacientes con retinopat.a diab.tica ocuparon el 28.7% del total de casos vistos. La retinopat.a diab.tica no proliferativa predomin. en los pacientes estudiados; sin embargo, 296 pacientes presentaron la forma proliferativa (17.8%) y 8 pacientes presentaron con edema macular cl.nicamente significativo. Conclusiones: El modelo de atenci.n oftalmol.gica que se implement. en las zonas rurales de la provincia de Anhui de manera gratuita y accesible, garantiz. el diagn.stico cl.nico y el tratamiento cl.nico y/o quir.rgico adecuado de las afecciones oculares m.s frecuentes que fueran catarata senil, pterigion, miop.a, retinopat.a diab.tica, elevando as. la calidad de la atenci.n oftalmol.gica de los pacientes, la familia y la comunidad local. Palabras Claves: Modelo de atenci.n oftalmol.gica; modelo cl.nico y quir.rgico. Introduction The models of Medical Care in the World, reflect the relationship between the different actors in the Health System, and the people who live in the Territory, based on Relationships of Trust and whose objective is to help achieve the bio Psycho-Social well-being of individuals, Families and Communities, which implies a holistic Vision of Health Care. In the second Hospital of Anhui Province implemented a model of eye care in the rural communities of free and accessible to the timely Diagnosis and Medical and Surgical Treatment designed to Elevate the quality of Eye Care. Material and method Model was applied in Clinical and Surgical Eye Care in four rural communities (Huainan of Anhui Province, Wuhu, Xuancheng, and Luan) from the Year 2013 to 2017, Eye conditions encountered in the various districts visited are Refractive Disorders (Diabetic Retinopathy, Senile Cataract, trachoma, pterygium, strabismus surgery and no obstruction of Roads lacrimal. Provides a Mobile Cart equipped with high technology and that meets the requirements for Clinical and surgical procedures. The Ophthalmology Team consisted of 6 members (5 doctors, 1 degree in Optics and Optometry and an Engineer in electromedicine. Coordination Board was established in our hospital, the Department of Labour and Social Security with local governments and Health Centres of the places to visit. Results: Of the total patients seen in consultation (1706), Myopia is 38.3% (2607 cases), Senile Cataract patients account for 25.8%. The rest of the eye diseases that were seen as non surgical strabismus in Children, trachoma and Dry Eye represent less than 10% of the total cases seen in consultation. Patients with Diabetic Retinopathy were 13.6% of the total cases. Have been operated a total of 2143 patients, 81.4% of them corresponds to Senile Cataract Surgery, have benefited from this programme 6494 patients with clinical diagnosis and 2153 had a Surgical Solution. Conclusions: The Model Eye care that is implemented in rural areas of Anhui Province accessible free of charge and ensures the clinical diagnosis and appropriate Clinical and/or Surgical Treatment of Eye Disorders frequently elevating the quality of eye care for Patients, Families and the Community. Keywords: Model of eye care, Clinical, and Surgical

Introduction: The models of medical care in the world reflect the relationship between the different actors of the health system and the people who live in the community, based on relationships of trust and help, whose objective is to achieve the biopsychosocial well-being of the people, families and communities, which implies a holistic vision of health care. In the Second Hospital of Anhui Province in China, an ophthalmological eye care model was implemented in rural communities free of charge and accessible with timely diagnosis and personalized medical-surgical treatment to improve the quality of ophthalmological care. Method: A clinical-surgical ophthalmological eye care model was applied in four rural communities in the province of Anhui (Huainan, Wuhu, Xuancheng, and Luan) from 2013 to 2017. The ocular affections found in the different districts visited were refractive disorders, senile cataract, myopia, diabetic retinopathy, pterygium, non-surgical strabismus and lacrimal obstruction. There was a car equipped with high technology, and that complied with the requirements for clinical and surgical procedures. The ophthalmology team consisted of 6 members (4 doctors, one graduate in optics and optometry and one engineer in electromedicine). Coordination was established with the Board of Directors of our hospital, the Department of Labor and Social Security, with the local governments and health centers of the places to visit. Results: Of the total number of patients seen in the office (7075), 57.3% corresponded to the male sex, aged 60 years and over. Patients with a diagnosis of senile cataract represented 2031 cases seen (28.7%); of them, 1754 had a surgical solution (81.4%). The left eye was the most operated and the IOL implanted was the foldable one. Minimal complications were reported such as rupture of the posterior capsule and endothelitis, the most frequent of which did not exceed 1%. Patients with diabetic retinopathy occupied 28.7% of the total cases seen. The non-proliferative diabetic retinopathy prevailed in the patients studied; however, 296 patients presented the proliferative form (17.8%) and eight patients presented with clinically significant macular edema. Conclusions The model of ophthalmological care that was implemented in the rural areas of the province of Anhui, free of charge and accessible, guaranteed the clinical diagnosis and the adequate clinical and/or surgical treatment of the most frequent ocular conditions presentede there such as senile cataract, pterygium. , myopia, diabetic retinopathy, thus raising the quality of the ophthalmological care of patients, family, and local community. Resumen Introducción: Los modelos de atención médica en el mundo reflejan la relación entre los distintos actores del sistema de salud y de las personas que viven en el territorio, basada en relaciones de confianza y ayuda, cuyo objetivo es lograr el bienestar biopsicosocial de las personas, familias y comunidades, lo que implica una visión holística del cuidado de la salud. En el Segundo Hospital de la provincia de Anhui en China, se implementó un modelo de atención oftalmológica en las comunidades rurales de forma gratuita y accesible con el diagnóstico oportuno y el tratamiento médico quirúrgico personalizado para elevar la calidad de la atención oftalmológica. Método: Se aplicó un modelo de atención oftalmológica clinico- quirúrgico en cuatro comunidades rurales de la provincia de Anhui (Huainan, Wuhu, Xuancheng y Luan) desde el año 2013 hasta 2017. Las afecciones oculares encontradas en los distintos distritos visitados fueran trastornos refractivos, catarata senil, miopía, retinopatia diabética, pterigion, estrabismo no quirúrgico y obstrucción de vías lagrimales. Se disponia de un carro móvil equipado con alta tecnología y que cumplia con los requerimientos para procedimientos clínicos y quirúrgicos. El equipo de oftalmología estuvo integrado por 6 miembros (4 médicos, 1 Licenciado en óptica y optometría y un ingeniero en Electromedicina). Se estableció coordinación con el Consejo de Dirección de nuestro hospital, el Departamento de Trabajo y Seguridad Social, con los gobiernos locales y centros de salud de los lugares a visitar. Resultados: Del total de pacientes vistos en consulta (7075), el 57.3 % correspondía al sexo masculino, con edades de 60 años y más. Los pacientes con diagnóstico de catarata senil representavan el 28,7%, con 2031 casos vistos; de ellos, 1754 tuvieron solución quirúrgica (81.4%). El ojo izquierdo fue el más operado y la LIO implantada fue la plegable. Se reportaron mínimas complicaciones como la ruptura de la cápsula posterior y endotelitis, las más frecuentes que no superaran el 1%. Los pacientes con retinopatía diabética ocuparon el 28.7% del total de casos vistos. La retinopatía diabética no proliferativa predominó en los pacientes estudiados; sin embargo, 296 pacientes presentaron la forma proliferativa (17.8%) y 8 pacientes presentaron con edema macular clínicamente significativo. Conclusiones: El modelo de atención oftalmológica que se implementó en las zonas rurales de la provincia de Anhui de manera gratuita y accesible, garantizó el diagnóstico clínico y el tratamiento clínico y/o quirúrgico adecuado de las afecciones oculares más frecuentes que fueran catarata senil, pterigion, miopía, retinopatía diabética, elevando así la calidad de la atención oftalmológica de los pacientes, la familia y la comunidad local.

Objective: To determine the predictive and diagnostic value of thorax trauma severity score (TTSS) in a population of thoracic trauma patients admitted to a secondary level trauma center. Methods: A Retrospective analysis of patients admitted over a period of two years with IDC-9 codes related to thoracic trauma was undertaken. The association of TTSS with complications and mortality was evaluated. We also determined the predictive value of TTSS using receiver operating characteristic curve (ROC). Results: 238 patients with thoracic trauma, mostly middle-aged (62.2 ± 15 years), were included. The main mechanisms of injury were falls and traffic accidents. Thirty-three patients had important extra-thoracic injuries, but only 9 presented an ISS> 15. The average ISS was 3 ± 5; Morbidity was 2.5% and mortality was 2.1% as a result of thoracic injury and these patients had significantly higher TTSS values. Each score component was analyzed separately, showing significant association with complications and mortality. The area under the curve for TTSS was significant for predicting complications (0.848) and mortality (0.856) values. TTSS with a cut off value of 8 points had a sensitivity of 66% and specificity of 94% to predict complications and 80% sensitivity and 94% specificity for predicting mortality. Conclusions: The TTSS is an appropriate and feasible tool to predict the development of complications or mortality in a population of mostly mild thoracic trauma.

Amongst other methods, political campaigns employ microtargeting, a specific technique used to address the individual voter. In the US, microtargeting relies on a broad set of collected data about the individual. However, due to the unavailability of comparable data in Germany, the practice of microtargeting is far more challenging. Citizens in Germany widely treat social media platforms as a means for political debate. The digital traces they leave through their interactions provide a rich information pool, which can create the necessary conditions for political microtargeting following appropriate algorithmic processing. More specifically, data mining techniques enable information gathering about a people's general opinion, party preferences and other non-political characteristics. Through the application of data-intensive algorithms, it is possible to cluster users in respect of common attributes, and through profiling identify whom and how to influence. Applying machine learning algorithms, this paper explores the possibility to identify micro groups of users, which can potentially be targeted with special campaign messages, and how this approach can be expanded to large parts of the electorate. Lastly, based on these technical capabilities, we discuss the ethical and political implications for the German political system.

Objetivo: identificar las características clínico-epidemiológicas del glaucoma crónico simple en personas mayores de 40 años, en el área de salud "Dr. Juan Manuel Páez Inchausti", Nueva Gerona, Isla de la Juventud. Métodos: se realizó un estudio descriptivo y transversal durante el segundo semestre de 2008, en una de las dos áreas de salud que cubren la atención primaria de la población de Nueva Gerona. Se chequeó el 98,8 % de la población mayor de 15 años y, después de aplicados los criterios de selección, fueron considerados 90 pacientes con diagnóstico previo de la enfermedad, de acuerdo con los parámetros estipulados para el seguimiento de esta. Se analizaron las variables edad, sexo, color de la piel, relación presión intraocular-excavación papilar, alteraciones campimétricas, síntomas y signos, antecedentes familiares de la enfermedad según grado de parentesco y enfermedades sistémicas y oculares asociadas con enfoque de riesgo. El procesamiento de la información se realizó mediante el método porcentual. Resultados: se reportó mayor número de pacientes entre 60 y 69 años (24,4 %), de mujeres (53,3 %) y de piel blanca (38,9 %). Los rangos predominantes de valores de presión intraocular y de excavación papilar fueron entre 16 y 21 mmHg (40,0 %), y entre 0,4 y 0,7 (37,8 %); en la relación entre ambas variables predominaron ambos rangos (16,7 %). Conclusiones: Las características clínico-epidemiológicas más relevantes del glaucoma crónico simple en los pacientes estudiados no difieren, en general, de lo reportado en la literatura, con excepción del predominio en mujeres de piel blanca, lo que puede deberse a la conformación de la muestra. La información obtenida del presente estudio debe considerarse parte del registro inicial de las características de la enfermedad en Cuba.Objective: To identify the clinical-epidemiological features of simple chronic glaucoma in persons aged over 40 in the "Dr. Juan Manuel Páez Inchausti" health area, Nueva Gerona, Isla de la Juventud municipality. Methods: A cross-sectional study was conducted during the second trimester of 2008 in one the health area covering the primary care of inhabitants of Nueva Gerona. The 98.8 % of patients aged over 15 was examined and after applications of selection criteria, 90 patients with a diagnosis previous to disease were considered according to the stipulated parameters for its follow-up. Following variables were analyzed: age, sex, skin color, relation intraocular-papillary excavation, campimetry alterations, symptoms and signs, family disease backgrounds according to the relationship degree and systemic and ocular diseases associated with risk approach. The information processing was made by conceptual method. Results: There was more reported patients aged between 60 and 69 (24.4 %), of women (53.3 %) and of white race (38.9 %). The predominant values ranks of intraocular pressure and of papillary excavation were between 16 and 21 mmHg (40.0 %), between 0.4 and 0.7 (37.8 %); in relation between both variables the two ranks predominate (16.7%). Conclusions: The more relevant clinical-epidemiological features of the simple chronic glaucoma in study patients not differing in general from that reported in literature, except the white race women predominance maybe due to sample conformation. The information obtained from present study must to be considered as part of initial registry of disease features in Cuba.

In this review mechanics of teratology, pharmacocinetic and pharmacodinamic of the anti-convulsives drugs are analyzed; we present special attention to pregnancy and therapeutic alternatives for pregnancy women with convulsive syndrome.

We develop a political economy model to study spatial spillover effects of remittances on local public goods with inter-regional positive externalities. Our model postulates that spillovers of remittances are asymmetric with a complex pattern that depends on the degree of externalities of public spending, the inter-regional inequality of income, and whether local public goods are complementary or substitutes. We develop several tests to be verified empirically, for instance, our model states that if local public goods are substitutes and externalities are moderate, remittances received by households in one locality increase government spending in that locality but reduce spending in other districts. If externalities are significant, remittances affect local public spending in high-income localities but do not affect spending in low-income localities. [ABSTRACT FROM AUTHOR]

Introduction: Diode laser cyclophotocoagulation constitutes a treatment alternative to increase the quality of life in patients with blind and painful eyes with absolute glaucoma. Materials and Methods: A retrospective comparative study was carried out in patients with absolute glaucoma of any etiology with the aim of comparing the effectiveness and safety of MicroPulse transscleral laser therapy (MP-TLT) versus continuous wave transscleral cyclophotocoagulation in eyes of patients with absolute glaucoma. A total of 104 eyes were studied and two groups were formed: 52 treated with CW and 52 eyes treated with MP. Baseline characteristics (number, proportions, mean, and standard deviation) were summarized and compared between the two groups using the Chi-square test. Results: Mean pain was 4.5 out of 10 for the group treated with CW and 5.75 for the group treated with MP. In the CW group, the success rate was 75.0% (P = 0.001); for MP, it was 70.8% (P = 0.002). A decrease in the number of topical antiglaucomatous drugs used was found for the CW group, from a mean of 2.9 eye drops ± 1 at the beginning of the study to 1.9 ± 1.2 at two years of investigation and MP from 3.1 ± 0.5 to 2.1 ± 0.5) and with acetazolamide (P = 0.001 and 0.002), respectively. Significant complications were in the CW group (hypotony in 3, 5.7% eyes, bulbar phthisis in 1, 1.9% eye, and corneal perforation 2, 3.8% eyes; P = 0.03). Conclusions: Both techniques reduced the painful component, being more stable over time with the use of continuous wave transscleral cyclophotocoagulation (CW-TSCP), which showed greater long-term intraocular pressure control, and a higher success rate, but with a significantly lower safety profile due to the number of complications presented. The number of topical antiglaucomatous drugs and acetazolamide was decreased with both procedures. [ABSTRACT FROM AUTHOR]

Se realizó una revisión bibliográfica con el objetivo de conocer las opciones quirúrgicas para la corrección del astigmatismo preoperatorio y posoperatorio en la cirugía de catarata. Fueron abordados tópicos como los estudios preoperatorios detallados que nos permiten realizar una planificación quirúrgica personalizada, así como las diferentes soluciones quirúrgicas actuales, tanto las incisiones anastigmáticas en la facoemulsificación, como las incisiones relajantes limbares combinadas o no con las lentes intraoculares tóricas y los procederes con excímer láser. Se consultaron investigaciones que abarcan varios años hasta el presente para conocer los diferentes resultados de la utilización de estos procederes quirúrgicos hasta llegar a técnicas más novedosas en estudio como el láser femtosecond y las lentes intraoculares ajustables con la luz. Todo esto puede maximizar la corrección refractiva total y lograr en el paciente una óptima calidad visual y una mejor calidad de vida. La corrección refractiva total no es fácil de lograr; no obstante, es posible y debe ser la meta de cada cirujano de catarata.

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