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Movimentos sísmicos são eventos de grande perigo para estruturas civis. Estes fenômenos ocorrem com maior intensidade em regiões próximas ao encontro de placas tectônicas. Para mitigar o efeito das vibrações, induzidas pela excitação de base criadas pelas ondas sísmicas, um dos dispositivos utilizados é um absorvedor de vibração denominado TMD (Tuned Mass Damper). Esses sistemas têm chamado a atenção de pesquisadores na última década, desenvolvendo estudos para melhorar seu desempenho. Nesse sentido, este trabalho apresenta o processo de otimização do comprimento, massa e taxa de amortecimento dum TMD alocado no topo da estrutura, as quais conduzem ao objetivo deste trabalho, que é minimizar a vibração da estrutura principal submetida a movimentos sísmicos. A pesquisa iniciou com a modelagem em elementos finitos de 3 estruturas esbeltas de grande altura, com períodos naturais de vibração diferentes. Em cada estrutura foi aplicada uma força estática, para obter a rigidez equivalente, correspondente a um sistema de 1 grau de liberdade (GDL). Em seguida, foi modelado um sistema massa-mola-amortecedor equivalente à estrutura original, à qual foi acoplado uma massa tipo pêndulo (TMD) com caraterísticas de comprimento, massa e taxa de amortecimento não otimizadas. Transformou-se, assim, a estrutura de muitos graus de liberdade em um sistema de 2 GDL (1 GDL da estrutura e1 GDL do pêndulo). Os 2 sistemas de 1 e 2 GDL foram submetidos a forças sísmicas mediante 9 registros de acelerações, para obter os deslocamentos máximos e o histórico do deslocamento durante a ação sísmica, e assim, comparar a variação desses parâmetros. Mediante métodos de teorias de otimização matemática foram obtidos os parâmetros ótimos do TMD, que em um 37% dos 27 casos em estudo, minimizaram as vibrações em um 50%, em mais de 70% dos casos minimizaram as vibrações pelo menos em 30% e somente um caso teve uma redução na vibração de 10%, concluindo que a alocação de um TMD com caraterísticas ótimas é uma boa opção para o controle de vibrações em estruturas altas e esbeltas submetidas a movimentos sísmicos. Earthquakes are some of the most dangerous events for civil structures. These phenomena occur with greater intensity in regions close to the encounter of tectonic plates. To mitigate the effect of vibrations, induced by the base excitation created by the seismic waves, one of the devices used is a vibration absorber called TMD (Tuned Mass Damper). Research into these systems has increased in the last decade, with a growing number of researchers developing studies for their best performance. This fact is reflected in the volume of publications and recent studies, compared to the past decades. In this sense, this work presents the process of optimization of the length, mass and damping rate of a TMD placed on top of the structure, which lead to the objective of this work, which is to minimize the vibration of the main structure subjected to seismic movements. The present work begins with the finite element modeling of a 3 slender high rise structure, with different natural periods of vibration, in each structure a static force was applied, to obtain the equivalent stiffness, corresponding to a 1 degree of freedom (DOF) system. Then, a mass-spring-damper system is modeled equivalent to the original structure, to which a pendulum-type mass TMD was attached, with characteristics of non-optimized longitude, mass and damping rate. The structure of many degrees of freedom is thus transformed into a system of 2 DOFs (1 DOF of the structure and 1DOF of the pendulum). The two systems of 1 and 2 DOF were subjected to seismic forces through 9 accelerations records, to obtain the maximum displacement and displacement history during the seismic action, and thus, compare the variation of these parameters. Through of methods of the mathematical optimization theories, the optimal parameters of TMD were obtained, which in 37% of the 27 cases, vibrations were minimized between 50% and 78%, in more than 70% of the cases, the minimization was of a minimum of 30% and only one case had a reduction in vibration of less than 10%, concluding that the placement of a TMD with optimal characteristics is a good option for vibration control in a tall and slender structures subjected to seismic movements.

The relationship between multiple hydroclimatic variables and vegetation conditions in the upper Madeira Basin (southwestern Amazon) has been analyzed. Vegetative dynamics are characterized using N...

The relationship between multiple hydroclimatic variables and vegetation conditions in the upper Madeira Basin (southwestern Amazon) has been analyzed. Vegetative dynamics are characterized using NDVI dataset as an indicator of the photosynthetic capacities of vegetation. Hydroclimatic variability is analyzed using satellite-based precipitation datasets, observed river discharge, and satellite measurements of terrestrial water storage (TWS). Our results show that the vegetation in the Basin varies from energy- to water-limited. During the peak of the wet season (January-February), rainfall, discharge, and TWS are negatively correlated with NDVI (r=-0.48 to -0.65), suggesting that during this period the vegetation is mainly energy-dependent. Outside this period, these correlations are positive (r=0.55 to 0.9), suggesting that vegetation depends mainly on water availability. This higher water dependence is more noticeable during the vegetation dry season (VDS; June-October). Considering the predominant land cover types, differences in the hydroclimate-NDVI relationship are observed. Evergreen forests remain energy-limited during the beginning of the VDS, but they become water-dependent almost at the end. Savannas show a different behavior, where water dependence occurs months before the onset of the VDS. On the other hand, unlike the other variables, the TWS better explains the NDVI in evergreen forests during the VDS (r=0.7 to 0.85). This is probably because evergreen forests are more dependent on deep soil water. A spatial analysis between hydroclimatic variables and the NDVI shows the predominance of positive correlations in most of the basin. However, specific areas do not show significant correlations. The weak relationship in these areas is explained by two factors i) very wet conditions during most of the year in the "rainfall hotspot" regions, where the vegetation is not water-limited, and ii) recent land-use changes (deforestation) that break the natural response in the hydroclimate-vegetation system. These findings provide new evidence on the impacts of the land cover changes on the natural relationship between vegetation and hydroclimatic variability, which is particularly relevant given the increasing rates of deforestation in this region during recent years.

IntroductionTelemedicine is an important element of healthcare. However, until the COVID-19 pandemic, training in telemedicine was not a substantial element of most residency programs. Social distancing measures changed this. The Cleveland Clinic Internal Medicine Residency Program (IMRP) is one of the largest programs in the United States, which made the task of developing and adopting an effective, expedited telemedicine curriculum challenging. Our goal was to implement a system for teaching telemedicine care skills and supervising the care provided by residents during virtual visits.MethodsThis study was started in April 2020. We developed and implemented a resident-led curriculum and training program for providing telemedicine care in less than five weeks. This entailed creating a formal training program for residents, creating a resource guide for the different video communication tools, and training preceptors to safely supervise care in this new paradigm. We also created an assessment instrument in our education evaluation system that allows residents to receive feedback on their performance during virtual appointments.ResultsOver 2000 virtual visits were performed by residents in a span of 10 weeks. Of 148 residents, 38% responded to the pre-participation survey. A majority had no prior telemedicine experience and expressed only slight comfort with the modality.DiscussionThrough collaboration with experienced residents and faculty, we expeditiously developed an enhancement to our ambulatory care curriculum to teach residents how to provide virtual care and help faculty with supervision. We share our insights on this experience for other residency programs to utilize.

The current information systems for the registration and control of electronic medical records (EMR) present a series of problems in terms of the fragmentation, security, and privacy of medical information, since each health institution, laboratory, doctor, etc. has its own database and manages its own information, without the intervention of patients. This situation does not favor effective treatment and prevention of diseases for the population, due to potential information loss, misinformation, or data leaks related to a patient, which in turn may imply a direct risk for the individual and high public health costs for governments. One of the proposed solutions to this problem has been the creation of electronic medical record (EMR) systems using blockchain networks, however, most of them do not take into account the occurrence of connectivity failures, such as those found in various developing countries, which can lead to failures in the integrity of the system data. To address these problems, HealthyBlock is presented in this paper as an architecture based on blockchain networks, which proposes a unified electronic medical record system that considers different clinical providers, with resilience in data integrity during connectivity failure and with usability, security, and privacy characteristics. On the basis of the HealthyBlock architecture, a prototype was implemented for the care of patients in a network of hospitals. The results of the evaluation showed high efficiency in keeping the EMRs of patients unified, updated, and secure, regardless of the network clinical provider they consult.

Background The vertebrate clade diverged into Chondrichthyes (sharks, rays, and chimeras) and Osteichthyes fishes (bony fishes) approximately 420 mya, with each group accumulating vast anatomical and physiological differences, including skin properties. The skin of Chondrichthyes fishes is covered in dermal denticles, whereas Osteichthyes fishes are covered in scales and are mucous rich. The divergence time among these two fish groups is hypothesized to result in predictable variation among symbionts. Here, using shotgun metagenomics, we test if patterns of diversity in the skin surface microbiome across the two fish clades match predictions made by phylosymbiosis theory. We hypothesize (1) the skin microbiome will be host and clade-specific, (2) evolutionary difference in elasmobranch and teleost will correspond with a concomitant increase in host-microbiome dissimilarity, and (3) the skin structure of the two groups will affect the taxonomic and functional composition of the microbiomes. Results We show that the taxonomic and functional composition of the microbiomes is host-specific. Teleost fish had lower average microbiome within clade similarity compared to among clade comparison, but their composition is not different among clade in a null based model. Elasmobranch’s average similarity within clade was not different than across clade and not different in a null based model of comparison. In the comparison of host distance with microbiome distance, we found that the taxonomic composition of the microbiome was related to host distance for the elasmobranchs, but not the teleost fishes. In comparison, the gene function composition was not related to the host-organism distance for elasmobranchs but was negatively correlated with host distance for teleost fishes. Conclusion Our results show the patterns of phylosymbiosis are not consistent across both fish clades, with the elasmobranchs showing phylosymbiosis, while the teleost fish are not. The discrepancy may be linked to alternative processes underpinning microbiome assemblage, including possible historical host-microbiome evolution of the elasmobranchs and convergent evolution in the teleost which filter specific microbial groups. Our comparison of the microbiomes among fishes represents an investigation into the microbial relationships of the oldest divergence of extant vertebrate hosts and reveals that microbial relationships are not consistent across evolutionary timescales.

Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq The study aimed to evaluate and compare the cardiorespiratory and analgesic parameters of continuous infusion of fentanyl, dexmedetomidine or maropitant in dogs submitted to ovariohysterectomy. Thirty healthy mixed breed bitches with an average body weight of 11±1.78 kg were evaluated. All animals received acepromazine (0.05 mg kg-1) intramuscularly as pre-anesthetic medication, anesthetic induction was performed with intravenous administration of propofol (5.51±0.67 mg kg-1), and anesthesia was maintained with isoflurane. Ten minutes after stabilization, continuous infusion was instituted, preceded by a bolus dose of the drugs evaluated, divided into the following groups: GF (fentanyl 2.0 g kg-1, 3.0 g kg-1 h- 1, n = 10), GD (dexmedetomidine 0.5 g kg-1, 1.0 g kg-1 h-1, n = 10) and GM (maropitant 1 mg kg-1, 150 g kg-1 h-1, n = 10). In the trans-operative period, cardiorespiratory parameters (HR, f, SBP, DBP, MBP, ETCO2, SpO2 and T° C) and analysis of arterial blood gases (pH, PaO2, PaCO2 and HCO3¯) were evaluated. Likewise, analgesic effects were assessed during surgery (trans-operatively) and after (post-operatively), recording cardiorespiratory parameters (HR, f, SBP, DBP, MBP) and using pain scales from the University of Melbourne (EDUM) and the Glasgow scale (EDG), respectively. In the evaluation of cardiorespiratory parameters, at some times, it was observed: lower HR in the GF and in the GD in relation to the baseline and the GM. However, the GF was larger compared to the GD. Blood pressure, compared to baseline, increased in the GF and the GD. Regarding the groups, the GF had lower blood pressure than the GD and higher blood pressure compared to the GM, while the GD was higher compared to the GM in blood pressure. The T° C, in relation to baseline, decreased in GD, GF and GM. in relation to f, ETCO2 and SpO2, there were no significant differences. In the measurements of arterial blood gas variables, there was a decrease in PO2 in the GF in relation to blood samples, while in the other variables pH, PCO2 and HCO3¯ there were no significant differences. The cardiorespiratory variables recorded for analgesic evaluation showed differences in time and between groups with greater pharmacological effect of each drug than with surgical nociceptive effects. In the postoperative analgesic evaluation, there were lower scores on the EDG in the GF, in the GD and in the GM compared to the first evaluation. In relation to the groups, there were lower scores in the GD and in the GM on the EDUM compared to the GF. From the results presented, it is suggested that the continuous infusion of maropitant has trans and postoperative antinociceptive effects, with few changes in cardiopulmonary parameters compared to the continuous infusion of dexmedetomidine or fentanyl O estudo teve por objetivo avaliar e comparar os parâmetros cardiorrespiratórios e analgésicos da infusão contínua de fentanil, dexmedetomidina ou maropitant em cadelas submetidas à ovariohisterectomia. Foram avaliadas 30 cadelas adultas saudáveis, sem raça definida, com peso corporal médio de 11±1,78 kg. Todos os animais receberam acepromazina (0,05 mg kg-1) por via intramuscular como medicação pré-anestésica, a indução anestésica foi realizada com a administração intravenosa de propofol (5,51±0,67 mg kg-1) e a anestesia foi mantida com isoflurano. Após a indução anestésica, os parâmetros cardiorrespiratórios e o plano anestésico foram estabilizados. Dez minutos após a estabilização, a infusão contínua foi instituída, precedida de uma dose em bolus dos fármacos avaliados, divididos nos seguintes grupos: GF (fentanil 2 g kg-1, 3 g kg-1 h-1, n = 10), GD (dexmedetomidina 0,5 g kg-1, 1 g kg-1 h-1, n = 10) e GM (maropitant 1 mg kg-1, 150 g kg-1 h-1, n = 10). No período trans-operatório, foram avaliados parâmetros cardiorrespiratórios (FC, f, PAS, PAD, PAM, ETCO2, SpO2 e T° C) e análise dos gases sanguíneos arteriais (pH, PaO2, PaCO2 e HCO3¯). Da mesma forma, os efeitos analgésicos foram avaliados durante a cirurgia (trans-operatório) e após (pós-operatório), registrando parâmetros cardiorrespiratórios (FC, f, PAS, PAD, PAM) e utilizando escalas de dor da Universidade de Melbourne (EDUM) e a escala de Glasgow (EDG), respectivamente. Na avaliação dos parâmetros cardiorrespiratórios, em alguns tempos, observou-se: menor FC no GF e no GD em relação ao basal e ao GM. No entanto, o GF foi maior em comparação com o GD. Na pressão arterial, comparada ao basal, aumentou no GF e no GD. Em relação aos grupos, o GF apresentou pressão arterial menor do que o GD e pressão arterial maior em relação ao GM, enquanto o GD foi maior em comparação ao GM em pressão arterial. A T° C, em relação ao basal, diminuiu no GD, GF e GM. Em relação à f, ETCO2 e SpO2 não houve diferenças significativas. Nas mensurações das variáveis dos gases sanguíneos arteriais, houve diminuição da PO2 no GF em relação às amostras de sangue, enquanto nas demais variáveis pH, PCO2 e HCO3¯ não houve diferenças significativas. As variáveis cardiorrespiratórias registradas para a avaliação analgésica apresentaram diferenças no tempo e entre os grupos com maior efeito farmacológico de cada fármaco do que com os efeitos nociceptivos cirúrgicos. Na avaliação analgésica pós-operatória, houve escores mais baixos na EDG no GF, GD e GM em comparação à primeira avaliação. Já em relação aos grupos, houve escores mais baixos no GD e no GM na EDUM em comparação ao GF. A partir dos resultados apresentados, sugere-se que a infusão contínua de maropitant têm efeitos analgésicos trans e pós-operatórios, com poucas alterações nos parâmetros cardiorrespiratórios em comparação à infusão contínua de dexmedetomidina ou fentanil.

Globally, soils store two to three times as much carbon as currently resides in the atmosphere, and it is critical to understand how soil greenhouse gas (GHG) emissions and uptake will respond to ongoing climate change. In particular, the soil-to-atmosphere CO(2)flux, commonly though imprecisely termed soil respiration (R-S), is one of the largest carbon fluxes in the Earth system. An increasing number of high-frequencyR(S)measurements (typically, from an automated system with hourly sampling) have been made over the last two decades; an increasing number of methane measurements are being made with such systems as well. Such high frequency data are an invaluable resource for understanding GHG fluxes, but lack a central database or repository. Here we describe the lightweight, open-source COSORE (COntinuous SOil REspiration) database and software, that focuses on automated, continuous and long-term GHG flux datasets, and is intended to serve as a community resource for earth sciences, climate change syntheses and model evaluation. Contributed datasets are mapped to a single, consistent standard, with metadata on contributors, geographic location, measurement conditions and ancillary data. The design emphasizes the importance of reproducibility, scientific transparency and open access to data. While being oriented towards continuously measuredR(S), the database design accommodates other soil-atmosphere measurements (e.g. ecosystem respiration, chamber-measured net ecosystem exchange, methane fluxes) as well as experimental treatments (heterotrophic only, etc.). We give brief examples of the types of analyses possible using this new community resource and describe its accompanying R software package.

Fluvial sediment dynamics plays a key role in the Amazonian environment, with most of the sediments originating in the Andes. The Madeira River, the second largest tributary of the Amazon River, contributes up to 50% of its sediment discharge to the Atlantic Ocean, most of it provided by the Andean part of the Madeira basin, in particular the Beni River. In this study, we assessed the rainfall (R)-surface suspended sediment concentration (SSSC) and discharge (Q)-SSSC relationship at the Rurrenabaque station (200 m a.s.l.) in the Beni Andean piedmont (Bolivia). We started by showing how the R and Q relationship varies throughout the hydrological year (September to August), describing a counter-clockwise hysteresis, and went on to evaluate the R&ndash, SSSC and Q&ndash, SSSC relationships. Although no marked hysteresis is observed in the first case, a clockwise hysteresis is described in the second. In spite of this, the rating curve normally used ( SSSC = aQ b ) shows a satisfactory R2 = 0.73 (p &lt, 0.05). With regard to water discharge components, a linear function relates the direct surface flow Qs&ndash, SSSC, and a hysteresis is observed in the relationship between the base flow Qb and SSSC. A higher base flow index (Qb/Q) is related to lower SSSC and vice versa. This article highlights the role of base flow on sediment dynamics and provides a method to analyze it through a seasonal empirical model combining the influence of both Qb and Qs, which could be employed in other watersheds. A probabilistic method to examine the SSSC relationship with R and Q is also proposed.

Key Points Question Does colchicine prevent intubation and mortality in hospitalized patients with COVID-19 pneumonia? Findings In this randomized clinical trial of 1279 patients hospitalized with COVID-19, patients allocated to receive colchicine plus usual care or to usual care alone demonstrated no significant difference in the coprimary outcome of mechanical ventilation or 28-day mortality. Meaning This randomized clinical trial found that colchicine did not significantly reduce the need for mechanical ventilation or 28-day mortality in patients hospitalized with COVID-19 pneumonia., This randomized clinical trial assesses the efficacy of colchicine in preventing mechanical ventilation and mortality in hospitalized patients with COVID-19 pneumonia., Importance Hospitalized patients with COVID-19 pneumonia have high rates of morbidity and mortality. Objective To assess the efficacy of colchicine in hospitalized patients with COVID-19 pneumonia. Design, Setting, and Participants The Estudios Clínicos Latino América (ECLA) Population Health Research Institute (PHRI) COLCOVID trial was a multicenter, open-label, randomized clinical trial performed from April 17, 2020, to March 28, 2021, in adults with confirmed or suspected SARS-CoV-2 infection followed for up to 28 days. Participants received colchicine vs usual care if they were hospitalized with COVID-19 symptoms and had severe acute respiratory syndrome or oxygen desaturation. The main exclusion criteria were clear indications or contraindications for colchicine, chronic kidney disease, and negative results on a reverse transcription–polymerase chain reaction test for SARS-CoV-2 before randomization. Data were analyzed from June 20 to July 25, 2021. Interventions Patients were assigned in a 1:1 ratio to usual care or usual care plus colchicine. Colchicine was administered orally in a loading dose of 1.5 mg immediately after randomization, followed by 0.5 mg orally within 2 hours of the initial dose and 0.5 mg orally twice a day for 14 days or discharge, whichever occurred first. Main Outcomes and Measures The first coprimary outcome was the composite of a new requirement for mechanical ventilation or death evaluated at 28 days. The second coprimary outcome was death at 28 days. Results A total of 1279 hospitalized patients (mean [SD] age, 61.8 [14.6] years; 449 [35.1%] women and 830 [64.9%] men) were randomized, including 639 patients in the usual care group and 640 patients in the colchicine group. Corticosteroids were used in 1171 patients (91.5%). The coprimary outcome of mechanical ventilation or 28-day death occurred in 160 patients (25.0%) in the colchicine group and 184 patients (28.8%) in the usual care group (hazard ratio [HR], 0.83; 95% CI, 0.67-1.02; P = .08). The second coprimary outcome, 28-day death, occurred in 131 patients (20.5%) in the colchicine group and 142 patients (22.2%) in the usual care group (HR, 0.88; 95% CI, 0.70-1.12). Diarrhea was the most frequent adverse effect of colchicine, reported in 68 patients (11.3%). Conclusions and Relevance This randomized clinical trial found that compared with usual care, colchicine did not significantly reduce mechanical ventilation or 28-day mortality in patients hospitalized with COVID-19 pneumonia. Trial Registration ClinicalTrials.gov Identifier: NCT04328480

Introducción: La rinitis alérgica es una condición común en gran parte de la población en general. Afecta aproximadamente al 32% de la población en general.Materiales y métodos: Estudio prospectivo en cohorte con un diagnóstico clínicode rinitis alérgica en el Hospital Universitario de La Samaritana; se evaluó el cuestionario ESPRINT-15 validado en español previo y 3 post-tratamiento con Beclometasona, Furoato de Mometasona y FluticasonaResultados: Se incluyeron 160 pacientes en el estudio. Previo al tratamiento, los pacientes tratados con Beclometasona y Mometasona no presentaban diferencia entre la puntuación global del cuestionario. Posterior al tratamiento, se evidenció que el grupo tratado con Furoato de Mometasona presentaba una reducción estadísticamente significativa en la severidad de síntomas (2.0 vs. 3.0, p

With 40 million amputees living in poor countries with limited access to health care, there is a significant need for novel prosthetic solutions. This paper presents our preliminary results to develop sustainable prostheses for five upper-extremity amputee patients in Colombia, South America. We utilized a patient-centric methodology, engaging patients at every stage in an effort to increase their satisfaction with their prosthetic and to assess clinical usefulness. We identified patient-specific criteria and compared existing open source hardware systems using the Design Thinking methodology. Finally, we present these data to further the development of myoelectric prosthetics as part of cyber-physical systems.

Introduction: The use of mobile applications has increased in the last years. Most of them require the knowledge of the user location, either for their core service or for marketing purposes. Location-based services (LBS) offer context-based assistance to users based on their location. Although these applications ask the user for permission to use their location and even explain in detail how this information will be used in its terms and conditions, most users are not aware or even interested in the fact that their location information is stored in databases and monetized by selling it to third-party companies. Regarding this situation, we developed a study with the aim to assess perception, concerns and awareness from users about their location information. Methods: This work is based on an exploratory survey applied to the university community, mainly from the North Coast of Colombia, to measure the perception of location privacy of users with mobile devices. The questionnaire was applied using Google Forms. The survey has nineteen questions organized in three sections: personal information, identification of privacy and privacy management. These questions were designed to know the users’ perceptions of privacy concerns in LBS and any actions they take to preserve it. Results: The results show that, in general, the respondents do not have a real concern regarding the privacy of their geolocation data, and the majority is not willing to pay to protect their privacy. Conclusions: This type of surveys can generate awareness among participants about the use of their private information. The results expose in this paper can be used to create government policies and regulations by technology companies about the privacy management. Introducción: El uso de aplicaciones móviles se ha incrementado en los últimos años. La mayoría de ellas requiere conocer la ubicación del usuario, ya sea para su servicio principal o para fines de marketing. Los servicios basados en localización (SBL) ofrecen asistencia contextual para los usuarios según su ubicación. Aunque estas aplicaciones le piden permiso al usuario para usar su ubicación e incluso explican en detalle cómo se usará esta información en sus términos y condiciones, la mayoría de los usuarios no están conscientes ni incluso interesados en el hecho de que la información de su ubicación se almacene en bases de datos y se monetice, vendiéndolo a terceros. Con respecto a esta situación, desarrollamos un estudio con el objetivo de evaluar la percepción, las preocupaciones y el conocimiento de los usuarios sobre la información de su ubicación. Métodos: este trabajo se basa en una encuesta exploratoria aplicada a la comunidad universitaria, principalmente de la costa norte de Colombia, para medir la percepción de la privacidad de ubicación de los usuarios con dispositivos móviles. El cuestionario se aplicó utilizando los formularios de Google. La encuesta tiene diecinueve preguntas organizadas en tres secciones: información personal, identificación de privacidad y gestión de la privacidad. Estas preguntas fueron diseñadas para conocer las percepciones de los usuarios sobre las preocupaciones de privacidad en SBL y cualquier acción que tomen para preservarla. Resultados: los resultados muestran que, en general, los encuestados no tienen una preocupación real con respecto a la privacidad de sus datos de geolocalización, y la mayoría no está dispuesta a pagar para proteger su privacidad. Conclusiones: este tipo de encuestas puede generar conciencia entre los participantes sobre el uso de su información privada. Los resultados expuestos en este documento se pueden utilizar para crear políticas y regulaciones gubernamentales por parte de las compañías de tecnología sobre la administración de la privacidad.

Background Electrical cardioversion is an effective and safe procedure in most patients. While left atrial thrombus is an absolute contraindication for elective cardioversion, there is very limited data on cardioversion in patients with left ventricular thrombus. We sought to better study the safety of cardioversion in this population. Methods We retrospectively reviewed all patients with the diagnosis of left ventricular thrombus on transthoracic echocardiogram (TTE) at our institution from 2010-2019. Patient were included in the study if they had undergone cardioversion and had had a TTE 4 weeks prior or 2 days after cardioversion showing left ventricular thrombus. Medical charts were reviewed for embolic events within three months after cardioversion. Results Out of 790 patients, 39 were included in the study. Mean age was 59.6 +/-14 years. The reason for cardioversion was atrial fibrillation/flutter (n = 14), ventricular arrhythmia (n = 14) and defibrillation threshold testing during defibrillator placement (n = 11). Mean time interval between the TTE and the cardioversion was 6 +/-6.3 days. Mean left ventricular ejection fraction was 24%+/-10%. Left ventricular thrombus was mobile (n = 3), fixed (n = 32) or calcified (n = 4). During a clinical follow-up period of 87+/-35 days, 28 patients (72%) were treated with warfarin, 2 patients (5%) with a direct oral anticoagulants, and 9 patients (23%) with anti-platelet therapy alone. No patient had an embolic complication during the follow-up. Conclusion Within the limitations of this study, cardioversion in patients with left ventricular thrombus appeared to be safe. Further larger studies are needed.

Electronic Medical Records - EMR has been an increasingly major area of research in order to improve quality of health services, by reducing attention time, probability of errors and helping all the actors in the ecosystem for accountability and traceability. However, patients are probably one of the actors that, despite being the main actor to be protected by regulations, have the least access to its information and control over what, who, when, how and why other actors in the healthcare system are doing with their information, especially in cases where just the existence of some tests may reveal an illness or a condition that should remain private. There is existing work and regulations on defining user-centered access control to the data, but the options are usually focused on defining policies on who has access to the information. This work introduces an incremental data access options in order to increase privacy over the data by considering the possibility of offering slightly altered or obfuscated data as an option to protect the original information, revealing just enough to enable the desired services. A differential privacy classification of access is presented, tested on lab data and evaluated, showing that different levels of privacy protection can be used in certain cases and for a limited number of services, while preserving privacy of the data. In addition, this technique can be integrated with other access-control techniques in literature.

Contar con una historia clinica completa de un paciente, en cualquier momento, constituye una herramienta valiosa que permite a los actores del sistema de salud, tales como medicos, enfermeras, farmaceutas, laboratoristas e incluso al mismo paciente, tomar mejores decisiones sobre los tratamientos medicos a seguir al contar con todos los antecedentes clinicos bien documentados. Sin embargo, en la actualidad solo se cuenta con un sistema fragmentado, no estandarizado, no interconectado, que Iimita el acceso a esta informacion de manera integral. En los ultimos tiempos se ha venido trabajando mecanismos para Iograr que esta centralizacion sea una realidad. Un ejemplo de ello es la Blockchain, que surge una tecnologia que permitiria la construccion de un sistema con informacion centralizada, pero no dependiente de una unica instancia, por su caracter participativo. Esta caracteristica serviria para implementar sistemas EMR (Electronic Medical Records) flexible, robusto y seguro para almacenar la informacion medica de los pacientes. Este trabajo presenta el diseno de la plataforma BD-MED para el uso de redes blockchain para el acceso, registro y almacenamiento del historial clinico de los pacientes, incluso en escenarios con fallas de conectividad.

Tailgut cysts, also known as retrorectal hamartomas, are very rare neoplasms located in the presacral/retrorectal space that originate from the embryonic hindgut. Although a majority of lesions in this location are benign, 30% of the reported cases in the literature were found to be malignant. This report describes a case of a presacral mass found on CT of a 37-year-old woman who initially presented with worsening abdominal pain and a history of ovarian cyst rupture. This patient's clinical picture was complicated by an enlarging ovarian cyst. The risk of progression to malignancy warranted excision. She recovered well with resolution of her presenting symptoms. We report this case along with a brief review of the literature with a focus on the surgical considerations.