Diuretic Treatment in Heart Failure: A Practical Guide for Clinicians.

Congestion and fluid retention are the hallmarks of decompensated heart failure and the major reason for the hospitalization of patients with heart failure. Diuretics have been used in heart failure for decades, and they remain the backbone of the contemporary management of heart failure. Loop diuretics is the preferred diuretic, and it has been given a class I recommendation by clinical guidelines for the relief of congestion symptoms. Although loop diuretics have been used virtually among all patients with acute decompensated heart failure, there is still very limited clinical evidence to guide the optimized diuretics use. This is a sharp contrast to the rapidly growing evidence of the rest of the guideline-directed medical therapy of heart failure and calls for further studies. The loop diuretics possess a unique pharmacology and pharmacokinetics that lay the ground for different strategies to increase diuretic efficiency. However, many of these approaches have not been evaluated in randomized clinical trials. In recent years, a stepped and protocolized diuretics dosing has been suggested to have superior benefits over an individual clinician-based strategy. Diuretic resistance has been a major challenge to decongestion therapy for patients with heart failure and is associated with a poor clinical prognosis. Recently, therapy options have emerged to help overcome diuretic resistance to loop diuretics and have been evaluated in randomized clinical trials. In this review, we aim to provide a comprehensive review of the pharmacology and clinical use of loop diuretics in the context of heart failure, with attention to its side effects, and adjuncts, as well as the challenges and future direction.

Management of patients with heart failure and chronic kidney disease.

Chronic kidney disease (CKD) and heart failure are often co-existing conditions due to a shared pathophysiological process involving neurohormonal activation and hemodynamic maladaptation. A wide range of pharmaceutical and interventional tools are available to patients with CKD, consisting of traditional ones with decades of experience and newer emerging therapies that are rapidly reshaping the landscape of medical care for this population. Management of patients with heart failure and CKD requires a stepwise approach based on renal function and the clinical phenotype of heart failure. This is often challenging due to altered drug pharmacokinetics interactions with various degrees of kidney function and frequent adverse effects from the therapy that lead to poor patient tolerance. Despite a great body of clinical evidence and guidelines that have offered various treatment options for patients with heart failure and CKD, respectively, patients with CKD are still underrepresented in heart failure clinical trials, especially for those with advanced CKD and end-stage renal disease (ESRD). Future studies are needed to better understand the generalizability of these therapeutic options among heart failures with different stages of CKD.

Exploring surface charge dynamics: implications for AFM height measurements in 2D materials.

An often observed artifact in atomic force microscopy investigations of individual monolayer flakes of 2D materials is the inaccurate height derived from topography images, often attributed to capillary or electrostatic forces. Here, we show the existence of a Joule dissipative mechanism related to charge dynamics and supplementing the dissipation due to capillary forces. This particular mechanism arises from the surface conductivity and assumes significance specially in the context of 2D materials on insulating supports. In such scenarios, the oscillating tip induces in-plane charge currents that in many circumstances constitute the main dissipative contribution to amplitude reduction and, consequently, affect the measured height. To investigate this phenomenon, we conduct measurements on monolayer flakes of co-deposited graphene oxide and reduced graphene oxide. Subsequently, we introduce a general model that elucidates our observations. This approach offers valuable insights into the dynamics of surface charges and their intricate interaction with the tip.

Amplification-Free Strategy for miRNA Quantification in Human Serum Using Single Particle ICP-MS and Gold Nanoparticles as Labels.

MicroRNAs (miRNAs), which are short single-stranded RNA sequences between 18 and 24 nucleotides, are known to play a crucial role in gene expression. Changes in their expression are not only involved in many diseases but also as a response to physiological changes, such as physical exercise. In this work, a new analytical strategy for the sensitive and specific analysis of miRNA sequences in human plasma is presented. The developed strategy does not depend on any nucleic acid amplification process and can be obtained in direct correlation to the number of events obtained by using single-particle ICP-MS measurements. The high selectivity of the assay (up to single nucleotide polymorphisms) can be achieved by a double hybridization process of the target miRNA with a complementary capture oligonucleotide that is conjugated to a magnetic microparticle and simultaneously with a complementary reporter oligonucleotide conjugated to a gold nanoparticle. Thanks to the novel approach followed in this method, the stoichiometry of the oligonucleotide-nanoparticle conjugates does not need to be addressed for the quantification of the target miRNA, which also represents a big advantage over other similar methods. The optimized method is applied to the determination of a miRNA as a biomarker of physical exercise in non-spiked human serum samples, and the results are validated against rt-qPCR. The achieved sensitivity permits the direct differentiation among sedentary and sportive subjects. This general platform can be easily applied to any other sequence by only modifying the capture and reporter oligonucleotides, paving the way for multiple clinically interesting applications.

Accurate Recapitulation of Chikungunya Virus Complete Coding Sequence Phylogeny Using Variable Genome Regions for Genomic Surveillance.

Chikungunya virus (CHIKV) is transmitted by mosquito bites and causes chikungunya fever (CHIKF). CHIKV has a single-stranded RNA genome and belongs to a single serotype with three genotypes. The Asian lineage has recently emerged in the Western Hemisphere, likely due to travel-associated introduction. Genetic variation accumulates in the CHIKV genome as the virus replicates, creating new lineages. Whole genome sequencing is ideal for studying virus evolution and spread but is expensive and complex. This study investigated whether specific, highly variable regions of the CHIKV genome could recapitulate the phylogeny obtained with a complete coding sequence (CDS). Our results revealed that concatenated highly variable regions accurately reconstructed CHIKV phylogeny, exhibiting statistically indistinguishable branch lengths and tree confidence compared to CDS. In addition, these regions adequately inferred the evolutionary relationships among CHIKV isolates from the American outbreak with similar results to the CDS. This finding suggests that highly variable regions can effectively capture the evolutionary relationships among CHIKV isolates, offering a simpler approach for future studies. This approach could be particularly valuable for large-scale surveillance efforts.

Bioaccessibility of trace elements and Fe and Al endogenic nanoparticles in farmed insects: Pursuing quality sustainable food.

This study investigated the in vitro bioaccessibility of aluminum, copper, iron, manganese, lead, selenium, and zinc in three important species of farmed insects: the yellow mealworm (Tenebrio molitor), the house cricket (Acheta domesticus) and the migratory locust (Locusta migratoria). Results show that all three insect species constitute excellent sources of essential elements (Fe, Cu and Zn) for the human diet, contributing to the recommended dietary allowance, i.e., 10%, 50%, and 92%, respectively. A higher accumulation of Se (≥1.4 mg Se/kg) was observed with increasing exposure concentration in A. domesticus, showing the possibility of using insects as a supplements for this element. The presence of Al and Fe nanoparticles was confirmed in all three species using single particle-inductively coupled plasma-mass spectrometry and transmission electron microscopy. The results also indicate that Fe bioaccessibility declines with increasing Fe-nanoparticle concentration. These findings contribute to increase the nutritional and toxicological insights of farmed insects.

Navigated Anterior Full-Endoscopic Transcervical Approach Odontoidectomy for Traumatic Posterior Atlantoaxial Dislocation Without Odontoid Fracture.

BACKGROUND AND IMPORTANCE: Complete posterior atlantoaxial dislocation (PAAD) with an unfractured odontoid process is a rare condition where a dislocated but intact odontoid process is positioned ventrally to the anterior arch of C1. This lesion is related to transverse and alar ligament rupture secondary to hyperextension and rotatory traumatic injury and is often associated with neurological deficit. The treatment strategy remains controversial, and in many cases, odontoidectomy is required. Traditional approaches for odontoidectomy (transnasal and transoral) are technically demanding and are related to several complications. This article describes a 360° reduction and stabilization technique through a navigated anterior full-endoscopic transcervical approach (nAFETA) as a novel technique for odontoidectomy and C1-C2 anterior transarticular fixation supplemented with posterior fusion. CLINICAL PRESENTATION: A 21-year-old man presented to the emergency room by ambulance after a motorcycle accident. On evaluation, incomplete ASIA B spinal cord injury was documented. Imaging revealed a complete PAAD. We performed a two-staged procedure, a nAFETA odontoidectomy plus C1-C2 anterior transarticular fixation followed by posterior C1-C2 wired fusion. At a 2-year follow-up, the patient had a 10-point Oswestry Disability Index score and neurological improvement to ASIA E. CONCLUSION: PAAD can be successfully treated through minimally invasive nAFETA. Noteworthy, the risks of the transoral and endonasal routes were avoided through this approach. In addition, nAFETA allows anterior transarticular fixation during the same procedure providing spinal stability. Further studies are required to expand the use of nAFETA in this field.

Enhancing Interaction between Lanthanum Manganese Cobalt Oxide and Carbon Black through Different Approaches for Primary Zn-Air Batteries.

Due to the need for decarbonization in energy generation, it is necessary to develop electrocatalysts for the oxygen reduction reaction (ORR), a key process in energy generation systems such as fuel cells and metal-air batteries. Perovskite-carbon material composites have emerged as active and stable electrocatalysts for the ORR, and the interaction between both components is a crucial aspect for electrocatalytic activity. This work explores different mixing methods for composite preparation, including mortar mixing, ball milling, and hydrothermal and thermal treatments. Hydrothermal treatment combined with ball milling resulted in the most favorable electrocatalytic performance, promoting intimate and extensive contact between the perovskite and carbon material and improving electrocatalytic activity. Employing X-ray photoelectron spectroscopy (XPS), an increase in the number of M-O-C species was observed, indicating enhanced interaction between the perovskite and the carbon material due to the adopted mixing methods. This finding was further corroborated by temperature-programmed reduction (TPR) and temperature-programmed desorption (TPD) techniques. Interestingly, the ball milling method results in similar performance to the hydrothermal method in the zinc-air battery and, thus, is preferable because of the ease and straightforward scalability of the preparation process.

The Experience of Cancer-Related Cognitive Impairment Across Common Cancers: Protocol for a Qualitative Systematic Review.

BACKGROUND: Cancer-related cognitive impairment (CRCI) is commonly experienced by patients with cancer during treatment, and 35% of patients experience cognitive impairment after treatment completion. Impairments in memory, attention, executive functioning, and information processing speed are most reported and often negatively impact daily functioning and quality of life (QoL). Despite the large scale of reports, this adverse side effect is underinvestigated across common cancer types, and there is a lack of insight into the CRCI experience. OBJECTIVE: This qualitative synthesis aims to explore the evidence in relation to the experience of CRCI across common cancers. It also aims to understand the prevalence of CRCI across various cancer types, cognitive domains, and its impact on QoL and functional ability. METHODS: A comprehensive search of databases, including PubMed, American Psychological Association PsycINFO, CINAHL, and Scopus, will be conducted. A total of 2 independent reviewers will screen titles and abstracts for inclusion, followed by full-text screening. A third reviewer will resolve any arising conflicts in the process of data screening and inclusion. Subsequently, data extraction and quality assessment using the Critical Appraisal Skills Programme (CASP) tool will be conducted. The results will be analyzed using thematic analysis. RESULTS: This review is part of a PhD program funded in January 2023. The review commenced in June 2023, and data analysis is currently in progress. The qualitative synthesis will explore the experiences of CRCI across common cancers. The included studies are expected to report on numerous cancer types such as breast cancer, prostate cancer, leukemia, and lung cancer. The included study types are most likely to be interviews, focus groups, and surveys with qualitative components. CONCLUSIONS: This protocol highlights the need for a qualitative synthesis that will explore the experience of CRCI across common cancer types. It will provide valuable insight into the lived experience of CRCI and the cognitive domains that may be disproportionately affected. There is a growing demand for further management interventions and clinically tested treatments of CRCI and the qualitative exploration of patient experience is crucial for their development. This qualitative synthesis will inform future developments and will contribute to improving QoL after cancer. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56888.

Development of an Enzyme-Linked Immunosorbent Assay (ELISA) as a tool to detect NS1 of dengue virus serotype 2 in female Aedes aegypti eggs for the surveillance of dengue fever transmission.

Dengue is a significant disease transmitted by Aedes mosquitoes in the tropics and subtropics worldwide. The disease is caused by four virus (DENV) serotypes and is transmitted to humans by female Aedes aegypti mosquito bites infected with the virus and vertically to their progeny. Current strategies to control dengue transmission focus on the vector. In this study, we describe an indirect Enzyme-Linked Immunosorbent Assay (ELISA), using a monoclonal antibody against the non-structural dengue virus protein 1 (NS1), to detect DENV2 in Ae. aegypti eggs. The assay detects NS1 in eggs homogenates with 87.5% sensitivity and 75.0% specificity and it is proposed as a tool for the routine entomovirological surveillance of DENV 2 in field mosquito populations.

Entamoeba histolytica: In Silico and In Vitro Oligomerization of EhHSTF5 Enhances Its Binding to the HSE of the EhPgp5 Gene Promoter.

Throughout its lifecycle, Entamoeba histolytica encounters a variety of stressful conditions. This parasite possesses Heat Shock Response Elements (HSEs) which are crucial for regulating the expression of various genes, aiding in its adaptation and survival. These HSEs are regulated by Heat Shock Transcription Factors (EhHSTFs). Our research has identified seven such factors in the parasite, designated as EhHSTF1 through to EhHSTF7. Significantly, under heat shock conditions and in the presence of the antiamoebic compound emetine, EhHSTF5, EhHSTF6, and EhHSTF7 show overexpression, highlighting their essential role in gene response to these stressors. Currently, only EhHSTF7 has been confirmed to recognize the HSE as a promoter of the EhPgp5 gene (HSE_EhPgp5), leaving the binding potential of the other EhHSTFs to HSEs yet to be explored. Consequently, our study aimed to examine, both in vitro and in silico, the oligomerization, and binding capabilities of the recombinant EhHSTF5 protein (rEhHSTF5) to HSE_EhPgp5. The in vitro results indicate that the oligomerization of rEhHSTF5 is concentration-dependent, with its dimeric conformation showing a higher affinity for HSE_EhPgp5 than its monomeric state. In silico analysis suggests that the alpha 3 α-helix (α3-helix) of the DNA-binding domain (DBD5) of EhHSTF5 is crucial in binding to the major groove of HSE, primarily through hydrogen bonding and salt-bridge interactions. In summary, our results highlight the importance of oligomerization in enhancing the affinity of rEhHSTF5 for HSE_EhPgp5 and demonstrate its ability to specifically recognize structural motifs within HSE_EhPgp5. These insights significantly contribute to our understanding of one of the potential molecular mechanisms employed by this parasite to efficiently respond to various stressors, thereby enabling successful adaptation and survival within its host environment.

Decoupled supercapacitive electrolyzer for membrane-free water splitting.

Green hydrogen production via water splitting is vital for decarbonization of hard-to-abate industries. Its integration with renewable energy sources remains to be a challenge, due to the susceptibility to hazardous gas mixture during electrolysis. Here, we report a hybrid membrane-free cell based on earth-abundant materials for decoupled hydrogen production in either acidic or alkaline medium. The design combines the electrocatalytic reactions of an electrolyzer with a capacitive storage mechanism, leading to spatial/temporal separation of hydrogen and oxygen gases. An energy efficiency of 69% lower heating value (48 kWh/kg) at 10 mA/cm2 (5 cm-by-5 cm cell) was achieved using cobalt-iron phosphide bifunctional catalyst with 99% faradaic efficiency at 100 mA/cm2. Stable operation over 20 hours in alkaline medium shows no apparent electrode degradation. Moreover, the cell voltage breakdown reveals that substantial improvements can be achieved by tunning the activity of the bifunctional catalyst and improving the electrodes conductivity. The cell design offers increased flexibility and robustness for hydrogen production.

A Myeloid-Specific Lack of IL-4Rα Prevents the Development of Alternatively Activated Macrophages and Enhances Immunity to Experimental Cysticercosis.

To determine the role that the IL-4/IL13 receptor plays in the development of alternatively activated macrophages (AAM or M2) and their role in the regulation of immunity to the extraintestinal phase of the helminth parasite Taenia crassiceps, we followed the infection in a mouse strain lacking the IL-4Rα gene (IL-4Rα-/-) and in the macrophage/neutrophil-specific IL-4Rα-deficient mouse strain (LysMcreIL-4Rα-/lox or cre/LoxP). While 100% of T. crassiceps-infected IL-4Rα+/+ (WT) mice harbored large parasite loads, more than 50% of th eIL-4Rα-/- mice resolved the infection. Approximately 88% of the LysMcreIL-4Rα-/lox mice displayed a sterilizing immunity to the infection. The remaining few infected cre/LoxP mice displayed the lowest number of larvae in their peritoneal cavity. The inability of the WT mice to control the infection was associated with antigen-specific Th2-type responses with higher levels of IgG1, IL-4, IL-13, and total IgE, reduced NO production, and increased arginase activity. In contrast, IL-4Rα-/- semi-resistant mice showed a Th1/Th2 combined response. Furthermore, macrophages from the WT mice displayed higher transcripts for Arginase-1 and RELM-α, as well as increased expression of PD-L2 with robust suppressive activity over anti-CD3/CD28 stimulated T cells; all of these features are associated with the AAM or M2 macrophage phenotype. In contrast, both the IL-4Rα-/- and LysMcreIL-4Rα-/lox mice did not fully develop AAM or display suppressive activity over CD3/CD28 stimulated T cells, reducing PDL2 expression. Additionally, T-CD8+ but no T-CD4+ cells showed a suppressive phenotype with increased Tim-3 and PD1 expression in WT and IL-4Rα-/-, which were absent in T. crassiceps-infected LysMcreIL-4Rα-/lox mice. These findings demonstrate a critical role for the IL-4 signaling pathway in sustaining AAM and its suppressive activity during cysticercosis, suggesting a pivotal role for AAM in favoring susceptibility to T. crassiceps infection. Thus, the absence of these suppressor cells is one of the leading mechanisms to control experimental cysticercosis successfully.

Genome-Wide Classification of Myb Domain-Containing Protein Families in Entamoeba invadens.

Entamoeba histolytica, the causative agent of amebiasis, is the third leading cause of death among parasitic diseases globally. Its life cycle includes encystation, which has been mostly studied in Entamoeba invadens, responsible for reptilian amebiasis. However, the molecular mechanisms underlying this process are not fully understood. Therefore, we focused on the identification and characterization of Myb proteins, which regulate the expression of encystation-related genes in various protozoan parasites. Through bioinformatic analysis, we identified 48 genes in E. invadens encoding MYB-domain-containing proteins. These were classified into single-repeat 1R (20), 2R-MYB proteins (27), and one 4R-MYB protein. The in-silico analysis suggests that these proteins are multifunctional, participating in transcriptional regulation, chromatin remodeling, telomere maintenance, and splicing. Transcriptomic data analysis revealed expression signatures of eimyb genes, suggesting a potential orchestration in the regulation of early and late encystation-excystation genes. Furthermore, we identified probable target genes associated with reproduction, the meiotic cell cycle, ubiquitin-dependent protein catabolism, and endosomal transport. In conclusion, our findings suggest that E. invadens Myb proteins regulate stage-specific proteins and a wide array of cellular processes. This study provides a foundation for further exploration of the molecular mechanisms governing encystation and unveils potential targets for therapeutic intervention in amebiasis.

The development and validation of a digital biomarker for remote assessment of Alzheimer's diseases risk.

Background: Digital cognitive assessment is becoming increasingly widespread in ageing research and care, especially since the COVID-19 pandemic. Remote online collection provides opportunities for ageing and dementia professionals to collect larger datasets, increase the diversity of research participants and patients and offer cost-effective screening and monitoring methods for clinical practice and trials. However, the reliability of self-administered at-home tests compared to their lab-based counterparts often goes unexamined, compromising the validity of adopting such measures. Objective: Our aim is to validate a self-administered web-based version of the visual short-term memory binding task (VSTMBT), a potential digital biomarker sensitive to Alzheimer's disease processes, suitable for use on personal devices. Methods: A final cross-sectional sample of 37 older-adult (51-77 years) participants without dementia completed our novel self-administered version of the VSTMBT, both at home on a personal device and in the lab, under researcher-controlled conditions. Results: ANOVA and Bayesian t-test found no significant differences between the task when it was remotely self-administered by participants at home compared to when it was taken under controlled lab conditions. Conclusions: These results indicate the VSTMBT can provide reliable data when self-administered at-home using an online version of the task and on a personal device. This finding has important implications for remote screening and monitoring practices of older adults, as well as supporting clinical practices serving diverse patient communities. Future work will assess remote administration in older adults with cognitive impairment and diverse socio-economic and ethno-cultural backgrounds as well as a bench-to-bedside application.

Bloqueo del músculo erector de la espina como rescate analgésico para control de dolor agudo postoperatorio en fractura de escápula: reporte de caso / Erector spinae plane block as an analgesic rescue to acute control postoperative pain in scapula fracture: case report

Resumen: Introducción: el bloqueo en el plano del músculo erector de la espina (ESPB, por sus siglas en inglés) es un procedimiento seguro, en teoría menos exigente que las técnicas convencionales de anestesia regional torácica. Se utiliza para el tratamiento del dolor agudo y crónico. En la revisión de la literatura, no se encontraron informes de su uso como una técnica única en el dolor agudo de fractura de escápula. Presentación de caso: se reporta un caso clínico de ESPB como técnica experimental para el control del dolor postoperatorio agudo en fracturas de la escápula con aplicación a nivel T2. Se llevó a cabo postoperatorio con disminución de dolor después de 10 minutos de realizado, con una calificación de cero en la escala análoga del dolor. En este caso el ESPB fue realizado en el postoperatorio inmediato, con lo que se logró una disminución total del dolor a los 10 minutos, con posterior control de dolor a las 36 horas. Conclusión: este caso muestra la efectividad de ESPB como técnica experimental para control de dolor postoperatorio en fractura de escápula.

Abstract: Introduction: the erector spine plane block (ESPB) is a safe procedure, technically is less demanding than conventional thoracic regional anesthesia techniques. It is used for the treatment of acute and chronic pain. In the literature review, no reports of its use as a single technique in the acute pain of scapula fracture were found. Case presentation: ESPB is reported in a case as an experimental technique for controlling acute postoperative pain in scapula fractures with an application at the T2 level. It was performed postoperatively with a decrease in pain after 10 minutes and a score of zero on the analog pain scale. In this case, the ESPB was performed in the immediate postoperative period, achieving a total decrease in pain at 10 minutes, with subsequent pain control at 36 hours. Conclusion: this case shows the effectiveness of ESPB as an experimental technique for postoperative pain control in scapula fractures.

Panamá en cifras: Tamizaje neonatal metabólico 2013 al 2018

Introducción: La Organización Mundial de la Salud considera el tamizaje neonatal como uno de los mayores logros en el programa de prevención de salud pública a nivel mundial, por su alta capacidad en identificar y tratar enfermedades a tiempo; evitando así discapacidad física y/o cognitiva.  La República de Panamá crea la ley 4 del 8 de enero de 2007 del Programa de Tamizaje que establece la obligatoriedad de la realización del tamizaje neonatal y dictan otras disposiciones. Materiales y métodos: Es un estudio descriptivo retrospectivo del tamizaje neonatal metabólico de la República de Panamá en el periodo 2013-2018. El universo estuvo constituido por todos los neonatos tamizados durante ese periodo. La muestra poblacional comprende datos del tamizaje neonatal metabólico del Ministerio de Salud, Caja de Seguro Social e instalación de Salud privada. Resultados: El promedio de número de Nacimientos vivos entre el periodo 2013 al 2018 fue de 75 mil recién nacidos anuales, el número de neonatos tamizados entre ese periodo el promedio fue 55 mil recién nacidos anuales con una cobertura promedio de 72.3% y una tasa de detección de tamizaje alterados promedio de 5.6% (promedio 3680 recién nacidos vivos). Discusión: La concientización de la población general y el personal de Salud sobre el tamizaje neonatal es vital para la prevención de discapacidad física, cognitiva y/o muertes infantiles. Conclusiones: El tamizaje neonatal tiene una tasa de detección de tamizajes alterados de un 5.6% anual, por el cual es importante mejorar la cobertura a nivel de la República de Panamá. (provisto por Infomedic International)

Introduction: The World Health Organization considers neonatal screening as one of the greatest achievements in the global public health prevention program, due to its high capacity to identify and treat diseases on time; thus, preventing physical and/or cognitive disability. The Republic of Panama creates: The Law number 4 of January 8, 2007, of the Screening Program that establishes the obligatory nature of neonatal screening and dictates other provisions. Materials and methods: It is a retrospective descriptive study of metabolic neonatal screening in the Republic of Panama in the period 2013-2018. The universe consisted of all newborns screened during that period. The population sample includes data from the metabolic neonatal screening of the Ministry of Health, Social Security Fund and private health facility. Results: The average number of live births between the period 2013 to 2018 was 75 thousand newborns per year, the number of newborns screened between that period was 55 thousand newborns per year with an average coverage of 72.3% and a detection rate of average altered screening of 5.6% (average 3680 live births). Discussion: The awareness of the general population and health personnel about neonatal screening is vital for the prevention of physical and cognitive disabilities and/or infant deaths. Conclusions: Neonatal screening has a detection rate of altered screenings of 5.6% per year, for which it is important to improve coverage at the level of the Republic of Panama (provided by Infomedic International)

Metodología para el desarrollo del sistema Web para la gestión de los programas de maestría del Instituto Pedro Kourí / Development Methodology of the Web System for the Management of Master's Programs at "Pedro Kourí" institute

Para llevar a cabo proyectos de desarrollo de software y como resultado final obtener un producto de alta calidad, con un bajo costo, un mínimo de esfuerzo y su entrega en tiempo, resultan fundamentales las actividades ejecutadas durante cada fase del proceso de construcción del software, en el que la identificación y elección de la metodología apropiada juegan un papel significativo para el éxito del proyecto. El objetivo del trabajo es proponer una metodología de desarrollo de software en ambiente web, para la gestión de los programas de maestrías del Instituto Pedro Kourí. Para llevar a cabo esta tarea se realizó una revisión sobre las metodologías de desarrollo de software existentes, los principios y fundamentos de las mejores prácticas para las metodologías ágiles y las tradicionales más relevantes en la actualidad, se estableció una comparación entre las metodologías seleccionadas y se propuso la metodología RUP (Rational Unified Process por sus siglas en inglés) para el desarrollo de los procesos de ingeniería de software del sistema web para la gestión de los programas de maestrías del Instituto Pedro Kourí(AU)

To carry out software development projects and as a final result obtain a high-quality product, with a low cost, a minimum of effort and its delivery on time, the activities carried out during each phase of the software construction process are fundamental, in which the identification and choice of the appropriate methodology play a significant role for the success of the project. The objective of the work is to propose a methodology for software development in a web environment, for the management of the master's programs of the Pedro Kourí Institute. To carry out this task, a review is carried out on the existing software development methodologies, the principles and foundations of best practices for agile methodologies and the most relevant traditional ones today, a comparison is established between the selected methodologies and the Rational Unified Process (RUP) methodology is proposed for the development of the software engineering processes of the web system for the management of the master's programs of the Pedro Kourí Institute(AU)

Prototipo de multimedia educativa para la enseñanza-aprendizaje de los indicadores del recurso cama hospitalaria. Cuba, 2020 / Educational Multimedia Prototype for teach-learn Indicators of Hospital Bed Resource. Cuba, 2020

Introducción: En la Facultad de Tecnología de la Salud se estudia la carrera Sistemas de Información en Salud que incluye en su plan de estudios diversas asignaturas como Sistemas de Información de Estadísticas de Salud, en la que se incluye el estudio de los indicadores hospitalarios del recurso cama; materia que se imparte de forma tradicional y no tiene una herramienta tecnológica de apoyo que facilite el proceso educativo. Objetivo: Diseñar un prototipo de multimedia educativa que favorezca el auto-aprendizaje de los indicadores del recurso cama hospitalaria en la asignatura Sistemas de Información de Estadísticas de Salud de la carrera Sistemas de Información en Salud. Método: Se realizó un estudio de desarrollo tecnológico donde fueron encuestados estudiantes y se entrevistó a la profesora de la asignatura para la obtención de la información. Se utilizó la metodología de Proceso Unificado de Desarrollo y el Lenguaje Unificado de Modelado. Se emplearon las herramientas Visual Paradigm para el modelado, Axure para la creación del prototipo y Mediator para el futuro diseño de la multimedia. Resultados: Se identificaron los problemas de aprendizaje desde la visión de alumnos y profesores, lo que permitió diseñar el prototipo de multimedia educativa sobre los indicadores hospitalarios del recurso cama, que fue considerado útil y pertinente. Conclusiones: Se diseñó un prototipo de multimedia educativa que de manera combinada con el método actual de enseñanza facilitarán y efectuarán de forma dinámica las actividades en el proceso docente educativo(AU)

Introduction: Health Information Systems career is included In the Faculty of Health Technology; the career have in its curriculum subjects as Health Statistics Information Systems, in which the study of hospital resource bed indicators is carried out; the subject is taught in a traditional way and does not have a technological support tool that facilitates the educational process. Objective: To design an educational multimedia prototype that favors self-learning of the indicators of the hospital bed resource in the Health Statistics Information Systems subject of the Health Information Systems career. Method: A survey of students and interview of teachers permitted to obtain the information needed to carry out a study of technological development using Unified Development Process methodology and Unified Modeling Language; Visual Paradigm tools were used for modeling; Axure for prototyping and Mediator for future multimedia design. Results: there were identified learning problems from the perspective of students and teachers, which allowed the design of the educational multimedia prototype on hospital bed resource indicators, considering it useful and pertinent. Conclusions: The design of the educational multimedia prototype, combined with the current teaching method, will facilitate and dynamically carry out the activities in the educational teaching process(AU)