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La partitura es un tipo de documento especializado sobre el que los traductores no reciben ninguna formación durante el transcurso de sus estudios reglados a pesar de que en la actualidad la música es una profesión cada vez más internacional y con una creciente necesidad de comunicación interlingüística. El sector de la traducción parece permanecer ajeno a esta realidad, lo que se manifiesta en una marcada ausencia de materiales bibliográficos a los que poder acudir ante un hipotético encargo de traducción de este tipo de documentos. Por ello, en el presente trabajo se examinan las características de la partitura y su contenido, así como su función en el marco de la composición de música contemporánea. A partir de los conocimientos obtenidos se hará una propuesta de los procedimientos que se deben seguir para abordar una traducción de este tipo y que posteriormente se aplicarán a la traducción de una partitura escogida para probar su utilidad.

Resumen Introducción y objetivo. El tratamiento quirúrgico del cáncer de mama ocasiona secuelas deformantes que repercuten negativamente en las pacientes. La reconstrucción mamaria es la etapa culminante de este tratamiento. En el Instituto Nacional de Oncología y Radiobiología (INOR) de La Habana, Cuba, se viene realizando con mayor frecuencia este proceder; por lo que nos propusimos caracterizar la reconstrucción mamaria en dicha institución. Material y método. Estudio ambispectivo en el Servicio de Cirugía Reconstructiva del Instituto Nacional de Oncología y Radiobiología de Cuba entre 2013 y 2017. La investigación incluyó 192 pacientes de las que recogimos variables demográficas y oncorreconstructivas. Resultados. Se realizaron una media de 38.4 cirugías anuales con un promedio de edad de las pacientes de 45.3 años. El 56.6% presentó mastectomía de Madden y el 34.4% se reconstruyó con técnicas ahorradoras de tejidos. El carcinoma ductal infiltrante se diagnosticó en 183 mujeres, el 38% presentó un cáncer en estadio II. La reconstrucción inmediata predominó en el 55.5% de las cirugías, en el 48.4% se utilizó la expansión tisular y en el 77.6% no se presentaron complicaciones. El cáncer en estadio III presentó una odds ratio (OR) estadísticamente significativa de 3.04 para las complicaciones posquirúrgicas. Conclusiones. La reconstrucción mamaria en el periodo estudiado se comportó de forma similar a estudios anteriores en el INOR; sin embargo, evidenciamos un aumento de la reconstrucción inmediata con técnicas conservadoras de mama y ahorradoras de piel y un incremento de las pacientes reconstruidas mayores de 50 años. Se presentaron pocas complicaciones y no identificamos factores de riesgo para la recidiva y el fallecimiento. Las pacientes con cáncer en estadio III presentaron un incremento de las complicaciones posquirúrgicas de la reconstrucción mamaria.

Surgical site infections (SSIs) are one of the main infection control problems in modern hospitals, significantly prolonging the stay at the hospital and increasing the cost of treating patients with infections. They are the leading cause of failure for both patients and staff, including the need for repeated surgeries. The objective of this study is the epidemiological and microbiological analysis, through neutrosophic statistical tools, of surgical site infections after vascular surgery in a highly specialized vascular surgery center in the city of Guayaquil, in which 327 vascular operations were performed, during the year 2019 and the follow-up of patients was taken into account as required, until 2020. The neutrosophic hypothesis tests applied allowed us to identify possible problems in the vascular surgery room from their comparison with multicenter studies described in the literature, specifically, from the National and State HAI Progress Report of the USA, as well as to rule out the classification of the state of the patient as a possible predictor of SSI diagnoses at this hospital.

Background: MOBILE and ENHANCE were similarly designed randomized trials of walking-impaired adults with relapsing-remitting or progressive multiple sclerosis (MS) who received placebo or 10 mg prolonged-release (PR)-fampridine twice daily for 24 weeks. Both studies showed sustained and clinically meaningful improvement in broad measures of walking and balance over 24 weeks of PR-fampridine treatment. Objective: To evaluate the functional benefits and safety of PR-fampridine versus placebo using a post hoc integrated efficacy analysis of MOBILE and ENHANCE data. Methods: Data from the intention-to-treat (ITT) populations of MOBILE and ENHANCE studies were pooled in a post hoc analysis based on the following outcome measures: 12-item MS Walking Scale (MSWS-12), Timed Up and Go (TUG) speed, Berg Balance Scale (BBS), MS Impact Scale physical impact subscale (MSIS-29 PHYS), EQ-5D utility index score, visual analogue scale (VAS), and adverse events. The primary analysis was the proportion of people with MS (PwMS) with a mean improvement in MSWS-12 score (⩾8 points) from baseline over 24 weeks. A subgroup analysis based on baseline characteristics was performed. Findings: In the ITT population ( N = 765; PR-fampridine, n = 383; placebo, n = 382), a greater proportion of PR-fampridine–treated PwMS than placebo-treated PwMS achieved a clinically meaningful improvement in the MSWS-12 scale over 24 weeks (44.3% versus 33.0%; p

Objective To describe mortality of in-hospital patients with COVID-19 and compare risk factors between survivors and non-survivors.Design Prospective cohort of adult inpatients.Setting Tertiary healthcare teaching hospital in Guadalajara, Mexico.Participants All patients with confirmed COVID-19 hospitalised from 25 March to 7 September 2020 were included. End of study: 7 November 2020.Primary outcome measures Patient survival analysed by the Kaplan-Meier method and comparison of factors by the log-rank test. Mortality risk factors analysed by multivariate Cox’s proportional-hazard model.Results One thousand ten patients included: 386 (38%) died, 618 (61%) alive at discharge and six (0.6%) remained hospitalised. There was predominance of men (63%) and high frequency of overweight–obesity (71%); hypertension (54%); diabetes (40%); and lung (9%), cardiovascular (8%) and kidney diseases (11%); all of them significantly more frequent in non-survivors. Overweight–obesity was not different between groups, but severity of disease (Manchester Triage System and quick Sequential Organ Failure Assessment) was significantly worse in non-survivors, who were also significantly older (65 vs 45 years, respectively) and had haematological, biochemical, coagulation and inflammatory biomarkers more altered than survivors. Mortality predictors were invasive mechanical ventilation (IMV; OR 3.31, p

Purpose: To compare the bone fusion of freeze-dried allograft alone versus freeze-dried allograft combined autograft in spinal instrumentation due to spondylodiscitis. Methods: A randomized prospective trial of patients with spondylodiscitis treated with surgical debridement and spinal fixation with freeze-dried bone allograft and autograft (Group 1) or freeze-dried bone allograft alone (Group 2) was performed. Patient follow-up was assessed with a CT-scan for bone fusion; consecutive serum inflammatory marker detection (C-reactive protein, [CRP], and erythrocyte sedimentation rate, [ESR]) and clinical assessment (pain, functional disability, and spinal cord injury recovery) were other outcome parameters. The primary outcome was the grade of bone allograft integration with the scale of Tan (which ranges from 1 to 4, with lower scores indicating a better fusion rate) at 1 year after surgery. Results: A total of 20 patients were evaluated, 13 (65%) men and 7 (35%) women with a mean age of 47.2 (±14.3) years. Homogeneous distribution of demographic data was observed. A similar satisfactory bone graft fusion grade was observed in both graft groups at 1 year after surgery (p = 1.0000). Serum inflammatory markers gradually decreased in both groups after surgical intervention (CRP, p < 0.001; ESR, p < 0.01). At one-year follow-up, gradual improvement of pain, functional disability, and neurological spinal injury recovery in both graft groups were achieved. Conclusion: Freeze-dried allograft alone could be a therapeutic option for spinal fixation surgery due to spondylodiscitis since it achieves a satisfactory graft fusion rate and clinical improvement. Level of Evidence: Level 1. Treatment ClinicalTrials.gov register: NCT03265561

El síndrome de Achenbach es una condición de etiología desconocida, caracterizado por cambios en la coloración de la piel de los dedos y asociado a dolor agudo. Existen pocos datos epidemiológicos, pero se estima que es una condición rara, que excepcionalmente aparece por debajo de los 40 años de edad. Presentamos el caso de una mujer joven a quien se dio el diagnóstico de síndrome de Achenbach por sus antecedentes y después de descartar patología reumática, vascular y metabólica. Comentamos datos sobre la patología y las diferencias que se encuentran con el caso que describimos.

Resumen: Introducción: Los estudios bibliométricos aplicados a las revistas científicas constituyen instrumentos que permiten evaluar su desempeño e impacto. Objetivo: Evaluar la producción científica de MEDICC Review en el período 2010-2015. Métodos: Se realizó un estudio bibliométrico descriptivo-retrospectivo. Las variables estudiadas fueron: total de números, total de artículos, citas, autocitas, promedio de citas por año, promedio de citas por artículos, promedio de citas por autores, promedio de citas por autores por año, promedio de artículos por autor, promedio de autores por artículo, índice h, índice g, índice h contemporáneo, índice h individual, índice h individual normalizado, índice AWCR, índice AW, índice AWCRpA, índice e, índice hm, índice h individual anual, amplitud H, amplitud G, tipología documental, afiliación de los autores, índice de Price, idioma de las referencias bibliográficas y SCImago Journal Rank. Se calcularon los indicadores cienciométricos mediante el software Harzing's Publish or Perish 5 tomando como base de datos el Google Académico. Se utilizó el paquete estadístico SPSS 22.0. Resultados: Se publicaron 274 artículos (86 originales) con 4.728 referencias bibliográficas (80,6% en inglés); el promedio de referencias por artículo fue de 17,3. La revista posee un índice h de 6 y un índice g de 7. El índice de Price osciló entre 0,17 y 0,84, con un valor promedio de 0,45. Predominaron los artículos de autoría cubana. La correlación lineal del número de citas en los últimos 2 años fue de R = 0,934 (p

Resumen: Introducción: La generación, difusión y promoción de conocimientos por medio de la investigación fueron consideradas funciones esenciales de la educación superior. La publicación científica estudiantil es un aspecto esencial en la educación de futuros profesionales de la salud. Cuba cuenta con 2 revistas científicas estudiantiles, las cuales pertenecen al área de las ciencias de la salud. Objetivo: Describir la producción científica de las revistas científicas estudiantiles cubanas. Material y métodos: Se realizó un estudio bibliométrico descriptivo en las revistas médicas estudiantiles cubanas Revista 16 de abril y Revista Universidad Médica Pinareña. Se analizaron los números correspondientes al período 2005-2015 de ambas revistas en su versión electrónica. Resultados: De un total de 680 artículos el 90,44% tuvo participación estudiantil. El mayor porcentaje correspondió a artículos originales. Solo 7 artículos fueron escritos íntegramente por autores extranjeros, de ellos 4 corresponden a publicaciones de profesionales; en 9 artículos hubo colaboración, de ellos 4 entre universidades de varios países. Conclusiones: Los resultados expresaron una estabilidad editorial en los últimos años, sin embargo no se cumple con los criterios de originalidad establecidos. Se encontró una colaboración internacional baja y elevada endogamia. Se espera que se establezcan políticas en función de mejorar la calidad de los procesos editoriales, lo que repercutirá directamente en un mejor posicionamiento de las revistas estudiantiles cubanas en el ámbito internacional. Abstract: Introduction: The generation, dissemination and promotion of knowledge through research were considered essential functions of higher education. The student scientific publication is an essential aspect in the education of future health professionals. Cuba has two student scientific journals, which publish in the health sciences area. Objective: To describe the scientific production of Cuban student scientific journals. Material and methods: A descriptive bibliometric study was performed on the Cuban medical student journals Revista 16 de Abril(16 April Journal), and Revista Universidad Médica Pinareña (Pinareña Medical University Journal). An analysis was made of issues of both Journals published in electronic format in the period 2005-2015. Results: There was 90.44% student participation out of a total of 680 articles. The highest percentage corresponded to original articles, with only 7 articles being fully written by foreign authors, including 4 correspond to professional publications. There were 9 collaboration articles, including 4 from universities in different countries. Conclusions: The results show editorial stability in recent years: however, they have not met with the criteria of originality established. There was very little international collaboration and a high level of endogamy. It is expected to establish policies based on improving the quality of the editorial process, which should lead directly to better positioning of Cuban student journals internationally. Palabras clave: Estudiantes de medicina, Educación médica, Revistas electrónicas, Publicaciones científicas y técnicas, Publicaciones seriadas, Keywords: Medical student, Medical education, Electronic journals, Scientific and technical publications, Serial publications

Cada vegada és més habitual trobar exemples de col·laboracions entre grups de recerca i serveis universitaris especialitzats. En aquest article es descriu la relació entre el Centre d’Història de la Ciència (CEHIC) i la Biblioteca de Ciència i Tecnologia de la Universitat Autònoma de Barcelona (UAB). A través de projectes concrets, amb necessitats i objectius comuns, aquesta relació ha generat activitats i productes, vinculats sobretot amb la incorporació i la publicació en el Dipòsit Digital de Documents de la UAB dels fons documentals gestionats pel Servei d’Arxius de Ciència del CEHIC.

Introducción y objetivos: La angiografía coronaria rotacional (ACR) permite reducir la cantidad de contraste administrado y puede prevenir el desarrollo de nefropatía inducida por contraste (NIC) durante los procedimientos coronarios invasivos. El objetivo del estudio es evaluar el impacto de la ACR en la aparición de NIC (aumento de creatinina ≥0,5 mg/dL o ≥25%) tras un síndrome coronario agudo. Métodos: De abril a septiembre de 2016 se seleccionaron prospectivamente pacientes con síndrome coronario agudo remitidos para coronariografía diagnóstica con posibilidad de angioplastia ad hoc, que fueron estudiados con ACR o angiografía coronaria convencional (ACC) según criterio del operador. Se compararon la NIC (variable de valoración primaria), variables analíticas, angiográficas y clínicas. Resultados: De 235 pacientes reclutados, 116 pacientes fueron estudiados con ACR y 119 pacientes con ACC. El grupo de ACR presentaba mayor edad (64,0 ± 11,8 vs. 59,7 ± 12,1 años; p = 0,006), más mujeres (44,8 vs. 17,6%; p

Introduction and objectives: Rotational coronary angiography (RCA) requires less contrast to be administered and can prevent the onset of contrast-induced nephropathy (CIN) during invasive coronary procedures. The aim of the study is to evaluate the impact of RCA on CIN (increase in serum creatinine â¥0.5 mg/dL or â¥25%) after an acute coronary syndrome. Methods: From April to September 2016, patients suffering acute coronary syndromes who underwent diagnostic coronary angiography, with the possibility of ad hoc coronary angioplasty, were prospectively enrolled. At the operator's discretion, patients underwent RCA or conventional coronary angiography (CCA). CIN (primary endpoint), as well as analytical, angiographic and clinical endpoints, were compared between groups. Results: Of the 235 patients enrolled, 116 patients received RCA and 119 patients received CCA. The RCA group was composed of older patients (64.0 ± 11.8 years vs. 59.7 ± 12.1 years; p = 0.006), a higher proportion of women (44.8 vs. 17.6%; pÂ

Aim: to confirm the diagnostic capacity in 18 hours of a methodology applied to heart dynamics in the frame of a chaotic exponential mathematical law previously applied in 21 hours based on dynamical systems theory and fractal geometry. Materials and methods: a blind study was developed with 100 Holter registries, 30 normal and 70 pathological, with lengths of at least 18 hours up to 21 hours. The values of heartbeats, as well as minimal and maximal heart rates, were taken to build attractors and quantify their fractal dimension and its occupation space with the Box-Counting method. A comparison between the values obtained for both 18 and 21 hours was made as well as a comparison with the clinical diagnostic Gold Standard. Results: the values obtained for the spaces of occupation in the grid Kp of 18 hours were between 202 and 374 and between 43 to 195 for the pathological ones. Sensitivity and specificity were 100% and the Kappa coefficient was 1 for 18 and 21 hours. Conclusion: the diagnostic capacity of a chaotic exponential mathematical law applied to Holter registries in 18 hours was confirmed. This reduction can be useful in order to obtain earlier diagnostics about heart dynamics in contexts such as in the Intensive Care Unit.

Insulin provides important information to tissues about feeding behavior and energy status. Defective insulin signaling is associated with ageing, tissue dysfunction, and impaired wound healing. In the liver, insulin resistance leads to chronic damage and fibrosis, but it is unclear how tissue-repair mechanisms integrate insulin signals to coordinate an appropriate injury response or how they are affected by insulin resistance. In this study, we demonstrate that insulin resistance impairs local cellular crosstalk between the fibrotic stroma and bipotent adult liver progenitor cells (LPCs), whose paracrine interactions promote epithelial repair and tissue remodeling. Using insulin-resistant mice deficient for insulin receptor substrate 2 (Irs2), we highlight dramatic impairment of proregenerative fibroblast growth factor 7 (Fgf7) signaling between stromal niche cells and LPCs during chronic injury. We provide a detailed account of the role played by IRS2 in promoting Fgf7 ligand and receptor (Fgfr2-IIIb) expression by the two cell compartments, and we describe an insulin/IRS2-dependent feed-forward loop capable of sustaining hepatic re-epithelialization by driving FGFR2-IIIb expression. Finally, we shed light on the regulation of IRS2 and FGF7 within the fibrotic stroma and show-using a human coculture system-that IRS2 silencing shifts the equilibrium away from paracrine epithelial repair in favor of fibrogenesis. Hence, we offer a compelling insight into the contribution of insulin resistance to the pathogenesis of chronic liver disease and propose IRS2 as a positive regulator of communication between cell types and the transition between phases of stromal to epithelial repair.

Motor imaging (MI) induces recovery and neuroplasticity in neurophysical regulation. However, a non-negligible portion of users presents insufficient coordination skills of sensorimotor cortex control. Assessments of the relationship between wakefulness and tasks states are conducted to foster neurophysiological and mechanistic interpretation in MI-related applications. Thus, to understand the organization of information processing, measures of functional connectivity are used. Also, models of neural network regression prediction are becoming popular, These intend to reduce the need for extracting features manually. However, predicting MI practicing’s neurophysiological inefficiency raises several problems, like enhancing network regression performance because of the overfitting risk. Here, to increase the prediction performance, we develop a deep network regression model that includes three procedures: leave-one-out cross-validation combined with Monte Carlo dropout layers, subject clustering of MI inefficiency, and transfer learning between neighboring runs. Validation is performed using functional connectivity predictors extracted from two electroencephalographic databases acquired in conditions close to real MI applications (150 users), resulting in a high prediction of pretraining desynchronization and initial training synchronization with adequate physiological interpretability.

Objectives. To describe the monitoring model of the Health Care Service Institutions (HCSI) of the National Health Authority (NHA) and assess the factors associated with risk-adjusted normative compliance (%RANC) within the Peruvian Health System (PHS). Materials and Methods. We carried out a case study of the experience of the NHA in the development and implementation of a monitoring program based on the ISO 31000-2009. With HCSI as the units of analysis, we calculated the %RANC (a score in continuous scale ranging from 0 to 100) for comprehensive monitoring (CM) and for specific evaluations made from 2013 to 2015. A higher score in the %RANC means lower operational risk. Also, slope coefficients (β) and their 95% confidence intervals (95% CI) were estimated using generalized linear models to estimate the association between %RANC as outcome, and health subsector, region, level of care and year, as explanatory variables. Results. The NHA made 1444 evaluations. For CM, only the Social Security Administration had higher %RANC than private centers (β=7.7%; 95% CI 3.5 to 11.9). The HCSI of the coastal region (β=-5.2, 95% CI -9.4 to -1.0), andean region (β=-12.5; 95% CI -16.7 to -8.3) and jungle region (β=-12.6, 95% CI% -17.7 to -7.6) had lower %RANC than those located in Lima Metropolitan area. %RANC was higher in 2015 than 2013 (β=10.8; 95% CI 6.4 to 15.3). Conclusions. The %RANC differs by health subsector, region and year of supervision. For CM, the HCSI in the Social Security Administration and in the Lima Metropolitan area had better scores, and scores improved over time. The implementation of actions aimed at improving %RANC in order to foster the full exercise of health rights in the PHS is suggested.

Objetivo: El propósito de este estudio fue analizar el impacto del programa de prevención mediante el diálogo socrático y el pensamiento crítico, en la depresión y la ansiedad. Materiales y métodos: Participaron 110 universitarios que accedían al primer año de la carrera; se utilizó un diseño experimental aleatorizado con grupo experimental y control. La variable independiente fue el diálogo socrático y el pensamiento crítico, y las variables dependientes fueron la sintomatología depresiva y/o ansiosa y los pensamientos negativos, positivos y ansiosos. Como instrumentos se utilizaron la Escala de depresión del Centro de Estudios epidemiológicos (CES-D), el Cuestionario revisado de 90 síntomas (SCL-90R), el Cuestionario de Pensamientos Automáticos Revisado (ATQ-TP), y el Cuestionario de Automanifestaciones Ansiosas (ASSQ). Resultados: Al comparar los resultados entre los dos grupos, se observó que el programa resultó efectivo en la reducción de los pensamientos negativos para el grupo experimental, aunque no se identificaron otros efectos. Conclusiones: El dialogo socrático y el pensamiento crítico - en el marco de un programa de prevención, reducen los pensamientos negativos en los universitarios de primer año.

Motor Imagery (MI) promotes motor learning in activities, like developing professional motor skills, sports gestures, and patient rehabilitation. However, up to 30% of users may not develop enough coordination skills after training sessions because of inter and intra-subject variability. Here, we develop a data-driven estimator, termed Deep Regression Network (DRN), which jointly extracts and performs the regression analysis in order to assess the efficiency of the individual brain networks in practicing MI tasks. The proposed double-stage estimator initially learns a pool of deep patterns, extracted from the input data, in order to feed a neural regression model, allowing for infering the distinctiveness between subject assemblies having similar variability. The results, which were obtained on real-world MI data, prove that the DRN estimator fosters pre-training neural desynchronization and initial training synchronization to predict the bi-class accuracy response, thus providing a better understanding of the Brain–Computer Interface inefficiency of subjects.

Chiapas: un médico por cada 1,500 habitantes, 30% de analfabetismo, 34% de las comunidades sin energía eléctrica, los peores salarios hasta 80% de viviendas con piso de tierra.

Fundamento: las malformaciones congénitas constituyen la primera causa de muerte infantil en los países desarrollados, así como la segunda causa de muerte en Cuba, en niños menores de un año de edad. Objetivo: caracterizar a los recién nacidos vivos con malformaciones congénitas en el municipio Marianao durante el año 2011. Métodos: estudio descriptivo, de corte transversal, de 30 recién nacidos vivos con malformaciones congénitas en el municipio Marianao, La Habana, durante el año 2011. Algunas de las variables analizadas, fueron: sexo, sistema afectado, malformación congénita, tipo de malformación, severidad, peso al nacer, edad gestacional, diagnóstico prenatal, antecedentes familiares de malformación congénita, edad materna, entre otras. Resultados: el sexo masculino fue el más afectado, con 18 casos que representaron el 60 % del total. La polidactilia fue la malformación más frecuente, con 23,3 %, seguida por el apéndice preauricular, con 10 %. El 20 % nació pretérmino y solamente en el 10 % de los casos se obtuvo un resultado positivo en exámenes de diagnóstico prenatal. Conclusión: los recién nacidos vivos con MC se caracterizaron por ser varones con MC aisladas y de menor severidad, a término, normopeso, sin antecedentes familiares de dicha afección y con un diagnóstico prenatal negativo. La mayoría de las madres pertenecían al grupo de edades de 20-35 años, padecían hipertensión arterial y durante el embarazo, las principales enfermedades que presentaron fueron las sepsis y la anemia.

In a commerical orchard of 18-year-old trees, 1250 fruits were chosen for observation. The majority of them abscised during the first weeks after anthesis. Afterwards, the abscission gradually descreased, however, in the meantime three additional waves of more intensive shedding occurred which were best visible when the Relative Abscission Rate (RAR) was calculated. The peaks in the RAR curve were preceded by a decrease in the Relative Growth Rate (RGR) of persistent fruits, which suggests that nutritional or other stresses occurred in the whole branch. In the period from May 15th to July 15th, predominantly the smaller fruits were abscised, later on, however, fruits of the same size as the persistent ones were shed. The formula for calculating RAR and RAR is shortly discussed.

The molecules of the title compound, [Cu2Br4(C10H8N2O2)2], are centrosymmetric dimers. The CuII atom exhibits a distorted square-pyramidal coordination geometry, with two bridging bromide ligands and the N atoms of the 4,4′-dihydroxy-2,2′-bipyridine chelate in the equatorial plane. π–π stacking and hydrogen-bonding interactions of the O—H...Br, C—H...·Br and C—H...O types consolidate the crystal packing.

Contexto: La primera idea que tuvieron los cirujanos (1902) para evitar amputaciones por isquemia fue la de desviar el flujo arterial al sistema venoso por intermedio de una fístula arteriovenosa entre vasos adyacentes, pero con resultados inciertos. Desde entonces se han inventado las simpatecomias, las endarteriectomias y los injertos puentes o bypass y, últimamente, otros avances médicos, quirúrgicos y endovasculares. Sin embargo, en el mundo se siguen haciendo amputaciones, sobre todo en diabéticos. La arterialización de las venas del pie, basada en la vieja idea de la circulación invertida, constituye una esperanza más para estos pacientes ya condenados a la pérdida del miembro. Objetivo: Demostrar que la arterialización de las venas del pie en diabéticos con lesiones neuroisquémicas, generalmente infectadas (pie diabético), es un método eficaz y durable, aunque el puente solo funcione temporalmente. Pacientes y método: De enero de 2000 a febrero de 2009, 59 pacientes con pie diabético fueron tratados por arterialización de las venas del pie. Un deceso precoz no ha sido contabilizado. De los 58 pacientes restantes, 44 fueron hombres y 14 mujeres, con edad promedio de 71 años: (53-91 años), 54 en estado IV de Fontaine y cuatro en estado IIIB. La arterialización fue hecha con un injerto venoso invertido anastomosado, proximalmente en una arteria con buen flujo (ilíaca externa, femorales o poplítea) distalmente en la vena marginal interna del pie, con destrucción de las válvulas de las venas del dorso. Resultados: De los 58 arterializados, 12 fueron fracasos por trombosis precoz, siendo amputados, y 46 fueron éxitos (79%): seis de corto, 12 de mediano y 28 de largo plazo. En los grupos que se ajustan a la definición de éxito (dos) hubo 38 trombosis tardías del puente (95%) y cuatro recidivas de la sintomatología isquémica. No ha habido ningún caso de sobrecarga cardíaca ni de várices. Conclusión: La arterialización en el pie diabético es posible, eficaz y durable, gracias, posiblemente, a la inducción de una neoarteriogénesis y neoangiogénesis, que mantiene los beneficios aun después de que el puente se haya ocluido (función temporal).Background: The first idea of surgeons (1902) to avoid amputations due to ischemia was to deviate the arterial flow to the venous system using an arteriovenous fistula between adjacent vessels; however, the results were unreliable. Since then, sympathectomies, endarterectomies and bypasses have been created, and more recently, other medical, surgical, and endovascular advances have been used. However, amputations continue to be performed worldwide mainly in diabetic patients. The arterialization of the foot veins, based on the old idea of inverted blood flow, is a new possibility for these patients who, otherwise, could lose their limbs. Objective: To demonstrate that arterialization of the foot veins in diabetic patients with neuroischemic lesions, usually infected (diabetic foot), is an effective and long-lasting method, even though the bypass only works temporally. Patients and method: From January 2000 to February 2009, 59 patients with diabetic foot were threated by means of arterialization of the foot veins. An early death was not included in the analysis. Of the 58 remaining patients, 44 were male and 14 were female. Their mean age was 71 years old: (53-91 years). Fifty-four of them were classified as being Fontaine IV and four were IIIB. The arterialization was conducted using an inverted venous graft proximally anastomized to an artery presenting good flow (external iliac, femoral or popliteal arteries) distally in the internal marginal vein of the foot, eliminating the valves of the foot arch veins. Results: Of the 58 patients who underwent arterialization, 12 failed due to early thrombosis, having amputated limbs, and 46 succeeded (79%): six at short-term, 12 at medium-term, and 28 at long-term. In the groups who were considered to have a successful outcome (two), there were 38 late bypass thrombosis (95%) and four relapses of the ischemic symptoms. There was no case of heart overload or varices. Conclusion: The arterialization of the diabetic foot is possible, effective and long-lasting probably thanks to the induction of a neo-arteriogenesis and neo-angiogenesis that maintain the benefits even after the bypass has occluded (temporal function).

El análisis multiescala es un área de gran actividad investigativa con fuerte impacto en computación científica y matemática aplicada, ocupando un lugar de privilegio en la forma como se entiende la relación entre la matemática y las demás ciencias. Aunque el estudio matemático de problemas multiescala está bastante documentado, estas técnicas heredan en el entorno discreto la naturaleza mal condicionada del problema. La molificación discreta ha sido empleada con éxito en la solución numérica de diversos problemas mal condicionados. Este árticulo propone una nueva técnica de análisis multiescala, basada en molificación discreta. El procedimiento aquí propuesto usa resultados de algebra lineal numérica para implementar molificación discreta en el algoritmo de Mallat. La nueva técnica tiene una teoría simple, una implementación eficiente y proporciona resultados de calidad comparable a técnicas multiescala clásicas tipo onditas (wavelet). El proceso es aplicado en señales electrocardiográficas contaminadas con ruido no blanco, para fines de comparación.

Introduction: Cardiovascular disease is now the leading cause of death in developed countries. The control of risk factors is an essential aspect for its prevention. The best tool for setting priorities in cardiovascular primary prevention is the risk estimate. Objective: To determine the prevalence of some cardiovascular risk factors and overall cardiovascular risk. Method: An observational, descriptive, cross-sectional study was conducted in individuals aged 40 to 79 years belonging to an urban health area, from December 2011 to March 2012. The universe consisted of 417 individuals who met the inclusion and exclusion criteria, and the sample consisted of 111 subjects, selected by simple random method. Results: The average waist circumference and waist-hip ratio in women were 92.72 ± 15.35 and 0.91 ± 0.06, respectively. The patients in the age group from 70 to 79 years had the highest prevalence of moderate to high risk in the study series (94.4%). The prevalence of moderate to high global cardiovascular risk in patients with diabetes mellitus and hypertension was 92.3 and 58.7%, respectively. Conclusions: There was a high prevalence of cardiovascular risk factors and moderate to high cardiovascular risk in subjects over 60 years of age, with diabetes mellitus and hypertension. There was a predominance of patients with low global cardiovascular risk, females and subjects under 60 years of age.

The Central University of Venezuela, as part of its efforts for adapting its academic offer to national and international needs, is conducting a project to review, evaluate and modify the Computer Science curriculum, in order to form the professional required by the country. In this paper we present the results of the first stage of the project: an assessment of the Computer Science curriculum based on the use of various data collection instruments used to determine the professor, student and graduates perception of the program as well as deficiencies and potential of our graduates, according to the companies and organizations that hire them. The results show that there exist a gap between the perception of our professors about the program and the opinion of the employers. We also present information about student performance during the last decade, which is an input to the next stage of the program redesign.

El presente artículo llega a un concepto sobre el cambio organizacional a partir de las respuestas que ofrece a cuatro preguntas: ¿Qué es lo que cambia en las organizaciones?, ¿Por qué cambian las organizaciones?, ¿Cómo cambian las organizaciones? y -entonces- ¿Qué es el cambio organizacional? Para lograr el propósito se toma como objeto a las organizaciones empresariales y se centra en las dimensiones donde se localizan los cambios, explora lo que algunos autores dicen sobre el cambio, revisa varias propuestas sobre las razones que llevan al cambio en las organizaciones, expone las modalidades en que cambian las organizaciones y, finalmente, como inferencia de lo expuesto, concluye en un concepto de cambio organizacional.

Insulin receptor substrate (IRS) proteins play important roles in hepatic nutrient homeostasis. Since glucokinase (GK) and glucokinase regulatory protein (GKRP) function as key glucose sensors, we have investigated the expression of GK and GKRP in liver of Irs-2 deficient mice and Irs2(-/-) mice where Irs2 was reintroduced specifically into pancreatic β-cells [RIP-Irs-2/IRS-2(-/-)]. We observed that liver GK activity was significantly lower (p

En este artículo, los autores presentan una propuesta pedagógica preliminar para evaluar competencias transversales de lectoescritura, según las necesidades que habían sido detectadas en investigaciones precedentes, para desarrollar capacidades genéricas de lectoescritura en todos los campos generales de formación en ciencias militares de la Escuela Militar de Cadetes “General José María Córdova”. Por lo demás, cabe destacar que ellos apelan simultáneamente a muchas competencias transversales, complementarias entre sí y de diversos órdenes que ponen de relieve diferentes facetas del saber-hacer: intelectuales, metodológicas, personales, sociales y comunicacionales. Ellos consideran esenciales estas competencias genéricas, llamadas competencias transversales, para que los alumnos puedan adaptarse a situaciones diversas y perseguir sus aprendizajes durante toda su vida, en la medida en que tales competencias sean objeto de intervenciones en todas las disciplinas y actividades de investigación, dado que ellas remiten a aspectos de formación que deben ser tenidos en cuenta para cada uno de los agentes escolares.

Los programas de diagnóstico precoz de hipotiroidismo congénito han demostrado la eficaz prevención del retraso mental. El problema científico actual consiste en la identificación de trastornos cognitivos sutiles que persisten a pesar del tratamiento precoz. Resulta favorable contar con procedimientos diagnósticos específicos diseñados para esto. Diferentes métodos indirectos sugieren que aunque se tengan cocientes de inteligencia dentro de rangos normales, el proceso de mantener la atención durante un intervalo de tiempo prolongado en estos niños se encuentra ligeramente comprometido. Este estudio tiene el objetivo de validar la eficiencia de una batería computadorizada SESH 1.O (sistema para evaluación y seguimiento de pacientes hipotiroideos) para la detección de trastornos en niños con hipotiroidismo congénito (HC). Se estudiaron 3 grupos de niños: trastornos del aprendizaje (TA), hipotiroidismo congénito (HC) y controles sanos (CS). Los resultados muestran que los valores de los niños del grupo HC se mantienen en un nivel intermedio entre los CS y los TA, lo que se interpreta como la existencia de un déficit subclínico en la atención sostenida. La capacidad discriminatoria del software empleado permite su incorporación inmediata a la práctica clínica del programa nacional de diagnóstico precoz de HC como un medio complementario de alta utilidad.The programs of early diagnosis of congenital hypothyroidism have proved the efficient prevention of mental retardation. The current scientific problem is the identification of subtle cognitive disorders persisting in spite of early treatment. It is convenient to have specific diagnostic procedures designed to this end. Different indirect methods suggest that even with intelligence quotients within the normal ranges, the process of maintaining attention during a prolonged time in these children is mildly compromised. This study is aimed at validating the efficiency of a SESH 1.0 computerized battery (system for evaluation and follow-up of hypothyroid patients) for the detection of disorders in children with congenital hypothyropidism (CH). Three groups of children were studied: learning disorders (LD), congenital hypothyroidism (CG) and sound controls (SC). The results show that the values of the children from group CH are at an intermediate level between the SC and the LD, which is interpreted as the existance of a subclinical deficit in sustained attention. The discriminatory capacity of the software used allows its inmediate incorporation to the clinical practice of the national CH early diagnosis program as a very useful complementary tool.

Abstract Background: The Gini coefficient is a statistical tool generally used by economists to quantify income inequality. However, it can be applied to any kind of data with unequal distribution, including heart rate variability (HRV). Objectives: To assess the application of the Gini coefficient to measure inequality in power spectral density of RR intervals, and to use this application as a psychophysiological indicator of mental stress. Methods: Thirteen healthy subjects (19 ± 1.5 years) participated in this study, and their RR intervals were obtained by electrocardiogram during rest (five minutes) and during mental stress (arithmetic challenge; five minutes). These RR intervals were used to obtain the estimates of power spectral densities (PSD). The limits for the PSD bands were defined from 0.15 to 0.40 Hz for high frequency band (HF), from 0.04 to 0.15 Hz for low frequency band (LF), from 0.04 to 0.085 Hz for first low frequency sub-band (LF1) and from 0.085 to 0.15 Hz for second low frequency sub-band (LF2). The spectral Gini coefficient (SpG) was proposed to measure the inequality in the power distribution of the RR intervals in each of above-mentioned HRV bands. SpG from each band was compared with its respective traditional index of HRV during the conditions of rest and mental stress. All the differences were considered statistically significant for p < 0.05. Results: There was a significant decrease in HF power (p = 0.046), as well as significant increases in heart rate (p = 0.004), LF power (p = 0.033), LF2 power (p = 0.019) and LF/HF (p = 0.002) during mental stress. There was also a significant increase in SpG(LF) (p = 0.009) and SpG(LF2) (p = 0.033) during mental stress. Coefficient of variation showed SpG has more homogeneity compared to the traditional index of HRV during mental stress. Conclusions: This pilot study suggested that spectral inequality of Heart Rate Variability analyzed using the Gini coefficient seems to be an independent and homogeneous psychophysiological indicator of mental stress. Also, HR, LF/HF, SpG(LF) of HRV are possibly important, reliable and valid indicators of mental stress.