Structure, Process, and Mortality Associated with Acute Coronary Syndrome Management in Guatemala's National Healthcare System: The ACS-GT Registry.

Background: Acute coronary syndromes (ACS) include ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). The leading cause of mortality in Guatemala is acute myocardial infarction (AMI) and there is no established national policy nor current standard of care. Objective: Describe the factors that influence ACS outcome, evaluating the national healthcare system's quality of care based on the Donabedian health model. Methods: The ACS-Gt study is an observational, multicentre, and prospective national registry. A total of 109 ACS adult patients admitted at six hospitals from Guatemala's National Healthcare System were included. These represent six out of the country's eight geographic regions. Data enrolment took place from February 2020 to January 2021. Data was assessed using chi-square test, Student's t-test, or Mann-Whitney U test, whichever applied. A p-value < 0.05 was considered statistically significant. Results: One hundred and nine patients met inclusion criteria (80.7% STEMI, 19.3% NSTEMI/UA). The population was predominantly male, (68%) hypertensive (49.5%), and diabetic (45.9%). Fifty-nine percent of STEMI patients received fibrinolysis (alteplase 65.4%) and none for primary Percutaneous Coronary Intervention (pPCI). Reperfusion success rate was 65%, and none were taken to PCI afterwards in the recommended time period (2-24 hours). Prognostic delays in STEMI were significantly prolonged in comparison with European guidelines goals. Optimal in-hospital medical therapy was 8.3%, and in-hospital mortality was 20.4%. Conclusions: There is poor access to ACS pharmacological treatment, low reperfusion rate, and no primary, urgent, or rescue PCI available. No patient fulfilled the recommended time period between successful fibrinolysis and PCI. Resources are limited and inefficiently used.

A Scheduling Scheme for Improving the Performance and Security of MU-MIMO Systems.

For the receiver of multiple-input multiple-output (MIMO) systems, linear detectors are an interesting option due to their good performance and low complexity. Nevertheless, MIMO systems lose diversity in exchange for eliminating interference when linear detectors are used. Aiming to maintain the system diversity while mitigating interference between users, this work proposes a scheduling scheme for the uplink of multiuser MIMO (MU-MIMO) systems that employ A antennas and the zero-forcing (ZF) detector at the receiver in the base station (BS). The channel model includes Rician fading and additive white Gaussian noise (AWGN) in an imperfect channel estimation scenario. The proposed scheme selects U users from a group of Ut users to transmit simultaneously, so that the signal-to-noise ratio (SNR) is maximized. For this, an exact expression to evaluate the SNR of the users is obtained. With this result, the scheduling strategy is proposed. Results show that as Ut increases, the outage probability (OP), and the bit error rate (BER) decrease as the system diversity increases, even when the system is completely loaded, i.e., when U=A. Moreover, it is shown that the scheduling scheme counteracts the imperfect channel estimation effects as Ut increases. Finally, the proposed scheme is tested in presence of an external eavesdropper trying to decode the information sent by the users. The results show that the presented proposal allows for a reduction of the secrecy-outage-probability (SOP) as Ut increases.

Trazas de ADN y su implicancia en la obtención de perfiles genéticos: revisión bibliográfica / Trace DNA and its implication in obtaining genetic profiles: bibliographic review

Introducción: El aumento en la sensibilidad de las técnicas empleadas ha permitido la obtención de perfiles genéticos a partir de trazas de ADN que se hayan depositado mediante contacto antes, durante o después de la comisión de los hechos investigados. Por otro lado, la contaminación accidental de los indicios biológicos, con la consecuente interpretación errónea de los resultados genéticos, tienen importantes consecuencias en el proceso judicial. Debido a ello, minimizar las contaminaciones que se pueden generar durante algunas de las fases de recolección o análisis genético, como así también la detección de estos eventos, es una prioridad para los laboratorios forenses. Objetivo: analizar las publicaciones más relevantes respecto a las trazas de ADN, los diferentes tipos de transferencia y contaminación que se pueden obtener en una evidencia. Metodología: se realizó la búsqueda en PubMed, del Instituto Nacional de Salud (NIH), y Google Académico usando las palabras clave en español e inglés: ADN de toque, Transferencia de ADN, Contaminación, Trazas, DNA-TTPR, Persistencia del ADN, Perfiles genéticos contaminados. Resultados: se encontraron más de 500 trabajos relacionados a la temática propuesta en esta revisión. El criterio de selección fue el número de citas, el enfoque y el impacto de estos. Se analizaron 71 artículos donde evaluaron la composición de las muestras de contacto y el origen del material genético que contienen. Además, de las metodologías de recolección, análisis de dichas muestras, la importancia que tiene la transferencia y contaminación del ADN en distintos escenarios posibles. Conclusión: existe riesgo de transferencia de ADN que puede conducir a resultados erróneos, por lo tanto es importante asegurar la actualización de los procedimientos de la práctica y brindar la capacitación adecuada para garantizar que el personal policial y del que recolecta indicios sea consciente de los riesgos de contaminación y de los diferentes mecanismos de transferencia de material genético...(AU)