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Introduction: The COVID-19 pandemic has had a significant social and health impact. Given the high risk of contagion and the potential collapse of the healthcare system, strategies such as social isolation, the use of personal protective equipment, and an increased reliance on telemedicine were adopted. These measures altered the dynamics of end-of-life patient care. Methodology: This observational cross-sectional study explored the experiences of home care staff providing end-of-life care and the impact of the pandemic on the care process, as well as on their quality of life and emotional well-being. A survey incorporating the adapted Care Of the Dying Evaluation (iCODE) questionnaire was conducted, alongside an assessment of quality of life using question 30 of the EORTC QLQ, and emotional wellbeing using the PANAS scale. Results: The experiences of 131 deceased patients were characterized. Professionals reported adequate therapeutic efforts in managing pain, dyspnea, and delirium. Additionally, they noted that the pandemic impeded treatment in 24% of the patients. The average quality of life score for professionals was 6 points, with a predominantly positive affect reported. Conclusions: Healthcare professionals in home-based care programs observed that the pandemic affected the treatment of nearly a quarter of end-of-life patients. Nonetheless, they highlighted that satisfactory symptomatic care and control were maintained. Additionally, they reported an adequate quality of life.

La cromatografía líquida de alta resolución (HPLC) es una de las técnicas empleadas para determinar la hemoglobina glicosilada (HbA1c) y el método de elección para el cribado de hemoglobinopatías estructurales. El objetivo de este caso es mostrar cómo en un análisis de rutina de HbA1c es posible encontrar incidentalmente una hemoglobinopatía.

Cation exchange high-performance liquid chromatography (HPLC) is one of the techniques available for determining glycated hemoglobin (HbA1c) and also the method of choice for structural hemoglobinopathies screening. The objective of this case is to show how in a routine HbA1c test it is possible to incidentally find a hemoglobinopathy.

The main objective of this work has focused on extending the existing literature on the analysis of total factor productivity of the Health Care Centers (HCC) of the Community of Madrid (Spain) in the period 2015-2017, with two important contributions; the application and comparison of the Malmquist indices with two robust methodologies such as the Hicks-Moorsteen and Färe Primont indices which, except for error, have not been previously used in this sector and the regional scope, which has been scarcely analyzed. The main results reveal decreases in HC productivity due to the three proposed methodologies. These decreases range between 4.90% and 0.25% for the Färe-Primont and Hicks-Moorsteen indices respectively between 2015/17 in average terms. Convergence analyses confirm that this takes place in the case of the Malmquist and Hicks-Moorsteen proposals. || El objetivo principal de este trabajo se ha enfocado en extender la literatura existente sobre el análisis de la productividad total de los factores, de los Centros Sanitarios de la Comunidad de Madrid en el periodo 2015-2017, con dos importantes contribuciones, la aplicación y comparación de los índices de Malmquist con dos metodologías robustas, los índices de Hicks-Moorsteen y Färe Primont que salvo error no han sido previamente utilizadas en este sector y el ámbito regional, que ha sido escasamente analizado. Los principales resultados revelan disminuciones de la productividad de los CS por las tres metodologías propuestas. Estas disminuciones oscilan entre 4.90% y 0.25% para los índices de Färe-Primont y de Hicks-Moorsteen respectivamente entre 2015/17 en términos medios. Los análisis de convergencia confirman que esta tiene lugar en el caso de las propuestas de Malmquist y Hicks-Moorsteen.

Background/Aims The objective of our study was to determine the epidemiological, laboratory, and serological characteristics of patients with chronic hepatitis B virus (HBV) infection and normal transaminases. The study also aimed to evaluate liver damage by measuring the liver fibrosis (LF) grade and to identify possible factors associated with the presence of fibrosis. Methods A retrospective observational study was conducted in patients with chronic HBV infection and classified as inactive carriers or immune-tolerant. Epidemiological variables of age, sex, immigrant, alcohol consumption, and body mass index (BMI), as well as virological variables (HBV DNA) and transaminase level were collected throughout the follow-up. The LF grade was evaluated by transient elastography. The cutoff value for significant fibrosis (SF) was liver stiffness ≥7.9 kPa. Results A total of 214 patients were included in the analysis, and 62% of them had a BMI ≥25 kg/m2. During follow-up, 4% of patients showed transaminase elevation (

La aplicación de las nuevas tecnologías en general y de los dispositivos móviles en particular a nuestra cotidianidad ha supuesto un cambio sustancial en la forma en que leemos, donde el texto electrónico está creando nuevos modos de acceder a la información, trabajarla, asimilarla y difundirla. En este artículo se analiza en primer lugar la acción de leer, los factores que influyen en la comprensión lectora y cómo se realiza el aprendizaje de la lectura. A continuación, se describen las características que definen hoy día la lectura desde un dispositivo electrónico. Y por último se reflexiona sobre el papel de la biblioteca como agente promotor de la lectura en este escenario digital.

El desarrollo de las nuevas tecnologías de la información y de la comunicación y su plena inserción en la vida personal y profesional ha traído consigo, además de un cambio en los modos de trabajo y de interrelación humana, la amplitud y/o modificación de los significados de algunos términos. El concepto de ‘olvido’ es uno de tantos. Este trabajo aborda dos áreas antagónicas del olvido con respecto a las nuevas tecnologías de la información y la comunicación: el olvido como la necesidad de que ‘Internet se olvide de mí’, y el olvido como la amenaza que puede verse paliada apoyándose en las posibilidades que Internet aporta. En primer lugar, se exponen los significados del término ‘olvido’. A continuación y pese a ser un problema global, nos centramos principalmente en las diferentes iniciativas en el marco de la Unión Europea en general y de España en particular, que se están llevando a cabo para regular el almacenamiento de información en la red y el derecho que el ciudadano tiene para reclamar el borrado de datos personales que atenten contra su intimidad y reputación. Por último, se analiza el estímulo terapéutico que los nuevos recursos tecnológicos pueden ofrecer para el tratamiento de enfermedades donde habita el olvido como son el Alzheimer y la amnesia.

In this paper we estimate the main parameters of some evaluation codes which are known as projective parameterized codes. We find the length of these codes and we give a formula for the dimension in terms of the Hilbert function associated to two ideals, one of them being the vanishing ideal of the projective torus. Also we find an upper bound for the minimum distance and, in some cases, we give some lower bounds for the regularity index and the minimum distance. These lower bounds work in several cases, particularly for any projective parameterized code associated to the incidence matrix of uniform clutters and then they work in the case of graphs.

La simulación ha demostrado ser una técnica potente y particularmente eficaz para valorar diferentes alternativas de solución de problemas, sin ser necesaria su experimentación real. En particular, resulta útil para la toma de decisiones cuando se desea organizar los puestos de trabajo en una organización donde existan variables que tengan un comportamiento aleatorio e influyan en los resultados. En este trabajo se propone utilizar la simulación discreta para el rediseño y organización del trabajo en un restaurante de comida criolla, el cual presenta problemas en su diseño actual (entre los que destacan: demoras en la atención a los clientes, aumento de los tiempos de espera para sentarse), lo que ha provocado una disminución en las ventas en el ultimo período. Con la simulación se realiza la modelización y evaluación de diferentes alternativas de organización del trabajo y, posteriormente, para el ordenamiento y la selección de la mejor alternativa, se utiliza el enfoque multicriterio en espacios discretos, específicamente el método analítico jerárquico desarrollado por Thomas Saaty, utilizando para ello el software “Jerarquías". || The simulation has proved a particularly effective and powerful technique to evaluate different alternatives for solving problems, without being required actual experimentation. It is particularly useful for decision-making when you want to organize jobs in an organization where there are variables that have random behavior and influence the results. This paper proposes to use the discrete simulation for redesign and organization of work in a local food restaurant, which presents problems in its current design (among which are: delays in customer service, increased time waiting to sit), which has caused a decline in sales in the fourth quarter. With the simulation, it is obtained the modelling and evaluation of different alternatives of work organization and later, for the ordering and the selection of the best alternative, multicriteria approach is used in discrete spaces specially the Analytic Hierarchic method, which was developed by Thomas Saaty, by using the software “Hierarchies".

We present the case of two children with cancer in the final stage of life, we describe the treatment given in this phase based on palliative sedation and analgesia to provide comfort to the patients and to offer calm to their relatives. We reviewed the literature information on support of sedation and analgesia at this stage of life, and the use of drugs such as midazolam and morphine. With the information provided in this article we expect physicians to convince themselves that opportune sedation and analgesia are useful and beneficial at the terminal stage of life.

In the culture of tilapia limited supply and high cost of fish meal have forced nutritionists to consider alternative sources of protein. Due to the importance of the products and by-products in fish feed, this paper aims to show the alternatives that have been used to partially or totally replace fish meal and soybean meal in tilapia growing. This paper showsthe maximum or optimal use of vegetable by-products for tilapia as cottonseed meal, sunflower, canola, soybean and Leucaena. It also deals with the inclusion with agro-industrial by-product such as corn, sorghum, coffee pulp, cocoa, wheat and citrus. The present study also deals with the use of aquatic plants such as Lemna and Azolla, single-celled plant protein source as antibiotics and probiotics. Finally, this paper also refers to animal by-products as silage, manure and earthworm usage. There is a high potential for using plant, livestock and agro-industrial by-products in fresh and processed food for the tilapia, but depending on the product, pretreatment to improve its balance of nutrients or eliminate anti-nutritional factors may be required.

In this paper we will compute the main parameters of the parameterized codes arising from cycles. In the case of odd cycles the corresponding codes are the evaluation codes associated to the projective torus and the results are well known. In the case of even cycles we will compute the length and the dimension of the corresponding codes and also we will find lower and upper bounds for the minimum distance of this kind of codes. In many cases our upper bound is sharper than the Singleton bound.

Fundamento: Los efectos de la diabetes tipo 2 en la microestructura y la masa ósea no están claramente definidos. El objetivo de este estudio ha sido valorar las propiedades microestructurales y la densidad mineral ósea volumétrica en ratas Goto-Kakizaki, modelo de ratas con diabetes tipo 2 sin sobrepeso que intenta soslayar la influencia de la obesidad sobre la masa ósea. Material y métodos: Se diseñó un estudio experimental con ratas Goto-Kakizaki frente a un grupo control de ratas Wistar no diabéticas de peso similar y con glucemias normales, realizándose estudios densitométricos y microestructurales de la región distal del fémur mediante microtomografía computarizada de rayos X (micro-CT). Resultados: En la densitometría volumétrica no se encontraron diferencias significativas entre los grupos. El estudio microestructural mostró que el BV/TV y la conectividad trabecular estaban disminuidos en las ratas diabéticas, a la vez que aumentaban las trabéculas en forma de tubo en detrimento de las trabéculas en forma de placa. Conclusión: El deterioro de la calidad ósea trabecular podría explicar el descenso de la resistencia biomecánica ósea en la diabetes tipo 2.