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Purpose: To evaluate the influence of atmospheric pressure changes on the behavior of intraocular pressure of healthy military individuals-students and instructors of the National Navy’s Diving & Rescue School at the “ARC BOLÍVAR” naval base-during a simulated immersion in the hyperbaric chamber of the Naval Hospital of Cartagena. Methods: A descriptive exploratory study was performed. The intraocular pressure was measured at different atmospheric pressures during 60-min sessions in the hyperbaric chamber while breathing compressed air. The maximum simulated depth was 60 feet. Participants were students and instructors of the Naval Base’s Diving and Rescue Department. Results: A total of 48 eyes from 24 divers were studied, of which 22 (91.7%) were male. The mean age of the participants was 30.6 (SD=5.5) years, ranging from 23 to 40. No participant had a history of glaucoma or ocular hypertension. The mean base intraocular pressure at sea level was 14 mmHg, which decreased to 13.1 mmHg (decreased by 1.2 mmHg) at 60 feet deep (p=0.0012). However, during the safety stop at 30 feet, the mean IOP kept decreasing until reaching 11.9 mmHg (p

ICOMVIS La detección de agentes infecciosos en animales de fauna silvestre en entornos urbanos es fundamental para su conservación y manejo. Dependiendo del tipo de agente infeccioso que los afecte, las implicaciones son relevantes tanto para su especie como para su entorno. El objetivo de este estudio fue identificar los agentes infecciosos en el zorro cangrejero (Cerdocyon thous) en las Áreas Protegidas Urbanas del Valle de Aburrá APU, Colombia. Se analizó la información obtenida de 24 zorros en las 6 Áreas Urbanas Protegidas APU y sus áreas de amortiguamiento. Entre febrero de 2020 y enero de 2021, se realizaron exámenes clínicos, se recolectaron muestras sanguíneas, materia fecal, orina y necropsias. Se recolectó la muestra fecal de 9 individuos, resultando 1 individuo positivo para huevos de Estrongilidos. En los resultados del laboratorio clínico (Hemogramas, citoquímico de orina, químicas sanguíneas) al no tener valores de referencia de la especie en el país, no es posible realizar una comparación de los valores obtenidos con los de referencia. Para la familia Anaplasmatacea, registré 3 (19%) resultados positivos en 16 muestras, 2 para Ehrlichia spp y 1 para Anaplasma spp. Para el agente Leptospira spp se procesaron 19 muestras con un resultado de 4 ejemplares positivos (21,05%). Los resultados encontrados son de importancia científica al ser el primer reporte de Leptospira interrogans por técnicas moleculares de análisis PCR en Colombia, la presencia de estos agentes infecciosos, indica la circulación de patógenos de importancia mundial por sus implicaciones en la salud pública, siendo un valioso aporte para las APU, llenando vacíos de información sobre el mamífero de mayor tamaño que las habitan y de esta manera poder adoptar medidas de manejo para su conservación. The detection of infectious agents in wild animals in urban environments is essential for their conservation and management. Depending on the type of infectious agent that affects them, the implications are relevant to both their species and their environment. The objective of this study was to identify the infectious agents in the crab-eating fox (Cerdocyon thous) in the Urban Protected Areas of Valle de Aburrá APU, Colombia. The information obtained from 24 foxes in the 6 APU Urban Protected Areas and their buffer zones was analyzed. Between February 2020 and January 2021, clinical examinations were carried out, blood samples, feces, urine and necropsies were collected. Fecal samples were collected from 9 individuals, resulting in 1 individual being positive for strongyle eggs. In the results of the clinical laboratory (CBC, urine cytochemical, blood chemistry) as there are no reference values ​​for the species in the country, it is not possible to compare the values ​​obtained with the reference values. For the Anaplasmatacea family, I recorded 3 (19%) positive results in 16 samples, 2 for Ehrlichia spp and 1 for Anaplasma spp. For the agent Leptospira spp, 19 samples were processed with a result of 4 positive specimens (21.05%). The results found are of scientific importance as it is the first report of Leptospira interrogans by molecular techniques of PCR analysis in Colombia, the presence of these infectious agents indicates the circulation of pathogens of global importance due to their implications in public health, being a valuable contribution for the APU, filling information gaps about the largest mammal that inhabits them and thus be able to adopt management measures for their conservation. Universidad Nacional, Costa Rica Instituto Internacional en Conservación y Manejo de Vida Silvestre

CAPES Os Sistemas Produto-Serviço (PSS) têm como finalidade satisfazer as necessidades dos clientes por meio de um serviço que integra produtos, redes de apoio e infraestrutura. Embora o PSS seja estudado por autores em nível mundial, existem muito poucos métodos para o projeto de PSS a partir da qualidade percebida pelo cliente. O propósito do presente trabalho é sugerir uma ferramenta que incorpore a voz do cliente nas etapas iniciais do desenvolvimento de Sistemas Produto-Serviço, visando criar um modelo de referência e propor as oportunidades de pesquisa futuras. Para atender o objetivo geral, é apresentada a fundamentação teórica baseada numa recompilação da literatura, passando pela definição de PSS, os diferentes tipos de PSS, as vantagens e barreiras na sua aplicação, diferentes modelos para o projeto de PSS e as ferramentas de apoio que incorporam a voz do cliente no Processo de Desenvolvimento de Produtos (PDP) e que, possivelmente, poderiam auxiliar o processo de projeto de PSS. A ferramenta que melhor abordou os requisitos do projeto de PSS é o desdobramento da função qualidade (QFD). O QFD é uma ferramenta efetiva para traduzir a voz do cliente em parâmetros de engenharia, capaz de introduzir o tema da qualidade no desenvolvimento de PSS. A proposta da presente dissertação parte dos trabalhos existentes da aplicação de QFD no projeto de PSS; são melhorados os trabalhos até agora desenvolvidos e exemplificadas por meio da aplicação do modelo numa lavanderia. O modelo para apoiar o desenvolvimento de PSS tem duas barreiras principais, que estão associadas com a avaliação qualitativa da matriz de relacionamento e com a possível complexidade em trabalhar grandes quantidades de requisitos e características de qualidade. Product-Service Systems (PSS) are designed to satisfy customers’ needs through a service that includes: products, support networks and infrastructure. Although many authors around the world have studied PSS, there are very few methods for service design based on the customers’ quality perception. The purpose of this work is to provide a tool that incorporates the customers’ voice at the early stages of the development of Product-Service Systems and, with this, to provide a reference model and propose future research opportunities. To meet the main objective, literature review was conducted, including the definition of PSS, the different types of PSS, the benefits and barriers of its implementation, different models for designing PSS and the support tools that incorporate the customer´s voice in the Product Development Process (PDP) and that could possibly assist the designing process of PSS. The tool that best addressed the requirements of the PSS design was the Quality Function Deployment (QFD). QFD is an effective tool for translating the customers’ voice into engineering parameters, as it is able to introduce the quality topic into the development of PSS. The starting point of the present work was to improve existing studies of QFD utilization in PSS development. Then the model is application is illustrated with a laundry business case. The model that supports PSS development has two main barriers, which are associated with the relationship matrix qualitative evaluation and with the possible complexity in working with large amounts of quality characteristics.

Se trata de un estudio observacional, descriptivo de tipo corte transversal mediante el cual se determino la prevalencia, alteraciones funcionales y estructurales del glaucoma primario de ángulo abierto (GPAA) en pacientes con apnea obstructiva del sueño (AOS). Se escogieron pacientes con diagnostico por polisomnograma de AOS entre 2013 y 2018, para determinar el índice de apena/hipoapnea (IAH) y los antecedentes clínicos, a los cuales se les realizó un examen oftalmológico que incluyo: agudeza visual (AV), biomicroscopia, presión intraocular (PIO), gonioscopía indirecta y oftalmoscopia. Los pacientes con sospecha de glaucoma se les efectuó campo visual y Tomografía Óptica de coherencia (OCT) de nervio óptico. Se estudiaron 150 pacientes con diagnóstico de AOS, para un total 300 ojos examinados, de los cuales 42,7% fueron mujeres y 57.3% hombres, con edad media 66.8 (± 12.1). En los antecedentes, 1.3% tenían antecedente familiar de glaucoma, 64.7% hipertensión arterial y 20.7% diabetes mellitus. El índice AIH se categorizo como leve en 62%, moderado en 17.3% y severo en 20.7%. La prevalencia de GPAA fue de 1.3% (IC:0.69-1.3%), mientras que para sospecha de glaucoma fue de 0.95% (IC:8.9-16.4%). La AV estuvo en el rango de 20/20 a 20/60 en el 94.6% de los casos, con una prevalencia de ceguera legal de 0.03% (IC:0.00 -0.14). La PIO media obtenida fue de 13 (± 2.6). En la valoración del nervio óptico, no se observaron alteraciones en 74.6% de casos, mientras las alteraciones mas frecuentes fueron adelgazamiento focal o difuso del reborde neural (16.6%) en el grupo de severidad leve, seguido por la asimetría del disco mayor a 0.2 mm (8.6%), en el grupo de severidad severa. En el campo visual, 54.4% no evidenciaron alteraciones y en el 41% restante presentaron defectos focales tipo arqueado, escalón nasal y paracentrales en el grupo de severidad leve. En los resultados del OCT, los valores fueron en mayor proporción normales, mientras, que los resultados anormales fue incrementando el daño estructural del nervio al pasar de AOS leve y moderado a severo. En conclusión, el estudio demostró relación entre los cambios estructurales del nervio óptico y la severidad de la AOS. Esto sugiriendo que la AOS puede influir en la anatomía del nervio óptico, favoreciendo al desarrollo de una neuropatía óptica y en cierto modo a la aparición de GPAA. Las alteraciones funcionales anormales en el campo visual indicaron que estadios leves del AOS pueden estar relacionados con mayores compromisos del campo visual. Asociado, las alteraciones estructurales anormales en la OCT fueron incrementando al pasar de AOS leve y moderado a severo, infiriendo asociación para el desarrollo de GPAA en paciente con AOS. Se recomienda la realización de futuros estudios clínicos para identificar la necesidad de realizar estudios y seguimientos a los pacientes con AOS para descartar glaucoma como una de sus múltiples manifestaciones sistémicas. RESUMEN.................................................................................................................3 IDENTIFICACIÓN Y FORMULACIÓN DEL PROBLEMA................................................... 6 OBJETIVOS E HIPÓTESIS..........................................................................................10 a. General .............................................................................................10 b. Específicos.........................................................................................10 c. Hipótesis............................................................................................10 METODOLOGÍA........................................................................................................11 a. Tipo y diseño general del estudio ...........................................................11 b. Lugar....................................................................................................11 c. Población ............................................................................................11 d. Variables y Mediciones...........................................................................11 e. Muestra................................................................................................14 a. Selección de la muestra.................................................................... 14 b. Calculo del tamaño de la muestra ......................................................14 c. Criterios de selección de inclusión y exclusión ..................................14 d. Mediciones e instrumentos utilizados.................................................14 e . Plan de recolección de datos...............................................................15 PLAN DE ANÁLISIS................................................................................................. 18 a. Métodos y modelos de análisis de los datos según tipo de variables b. Programas a utilizar para análisis de datos. c. Control de sesgos ASPECTOS ÉTICOS ................................................................................................18 RESULTADOS .........................................................................................................19 DISCUSIÓN ............................................................................................................ 23 CONCLUSIONES...................................................................................................... 26 REFERENCIAS BIBLIOGRÁFICAS ............................................................................. 26 This is an observational, descriptive, cross-sectional study that determines the prevalence, functional and structural alterations of primary open-angle glaucoma (POAG) in patients with obstructive sleep apnea (OSA). Patients between 2013 and 2018 with diagnosis of OSA by polysomnogram were chosen to determine the apnea/hypopnea index (AHI) and antecedents. Patients underwent an ophthalmological examination that included: visual acuity (VA), biomicroscopy, intraocular pressure (IOP), indirect gonioscopy and ophthalmoscopy. Patients with diagnosis of glaucoma suspect underwent a visual field and Optical Coherence Tomography (OCT) of the optic nerve. It was studied 150 patients with a diagnosis of OSA, for a total of 300 eyes examined, of which 42.7% were women and 57.3% men, with a mean age of 66.8 (± 12.1). In the antecedents, 1.3% had a family history of glaucoma, 64.7% hypertension, and 20.7% diabetes mellitus. The AIH index was categorized as mild in 62%, moderate in 17.3% and severe in 20.7%. The prevalence of POAG was 1.3% (CI:0.69-1.3%), while for glaucoma suspect was 0.95% (CI:8.9-16.4%). VA was in the range of 20/20 to 20/60 in 94.6% of the cases, with a prevalence con legal blindness od 0.0% (CI: 0.00-0.14). The mean IOP obtained was 13 (± 2.6). In the evaluation of the optic nerve, no alterations were observed in 74.6% of cases, while the most frequent alterations were focal or diffuse thinning of the neural rim (16.6%), in the mild severity group, followed by disc asymmetry greater than 0.2 mm (8.6%), in the severe severity group. In the visual field, 54.4% did not show alterations and in the remaining 41% presented arcuate, nasal step and paracentral focal defects in the mild severity group. In the OCT results, the values were normal in a higher proportion without significant differences. In patients with abnormal results, the structural damage of the nerve increased from mild and moderate OSA to severe. In conclusion, the study demonstrated a relationship between the structural changes of the optic nerve and the severity of OSA. This suggests that OSA can influence the anatomy of the optic nerve, favoring the development of optic neuropathy and, to a certain extent, the appearance of POAG. The abnormal functional alterations in the visual field indicated that mild stages of OSA may be related to greater visual field compromises. Associated, abnormal structural alterations in OCT increased from mild and moderate OSA to severe, inferring an association for the development of POAG in a patient with OSA. Future clinical studies are recommended to identify the need for studies and follow-ups of patients with OSA to rule out glaucoma as one of its multiple systemic manifestations. Especialización