Universidad Católica de Cuenca

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing.

In Brief Objective: To assess the age at menopause (AM) in Latin America urban areas. Design: A total of 17,150 healthy women, aged 40 to 59 years, accompanying patients to healthcare centers in 47 cities of 15 Latin American countries, were surveyed regarding their age, educational level, healthcare coverage, history of gynecological surgery, smoking habit, presence of menses, and the use of contraception or hormone therapy at menopause. The AM was calculated using logit analysis. Results: The mean age of the entire sample was 49.4 ± 5.5 years. Mean educational level was 9.9 ± 4.5 years, and the use of hormone therapy and oral contraception was 22.1% and 7.9%, respectively. The median AM of women in all centers was 48.6 years, ranging from 43.8 years in Asuncion (Paraguay) to 53 years in Cartagena de Indias (Colombia). Logistic regression analysis determined that women aged 49 living in cities at 2,000 meters or more above sea level (OR = 2.0, 95% CI: 1.4-2.9, P < 0.001) and those with lower educational level (OR = 1.9, 95% CI: 1.3-2.8, P < 0.001) or living in countries with low gross national product (OR = 2.1, 95% CI: 1.5-2.9, P < 0.001) were more prone to an earlier onset of menopause. Conclusions: The AM varies widely in Latin America. Lower income and related poverty conditions influence the onset of menopause. To avoid biases, logit analysis has been used to calculate the age at menopause as the percentage of women in amenorrhea at different ages. The major factors that increase the risk of an earlier age at menopause were living at altitudes above 2,000 meters and low socioeconomic and educational level.

Buildings are one of the most important energy consumers in modern economy countries. The massive use of electrical vehicles could help decarbonizing the economy by using electricity produced using renewable energy. Combined use of Vehicle to Grid (V2G), Vehicle to Home (V2H) and Vehicle to Building (V2B) is one of the strategies to increase the number of electrical vehicles, ensure a better coupling between energy generation and consumption, reducing peak demand and increasing global energy efficiency. This research presents a novel approach of combined use of V2H and V2B that can be applied in different scenarios such as when the building workers own EVs, company shared car fleets or leasing, among others. Recharged energy at workers homes during night hours is delivered in the building during daily working hours lowering peak demand, reducing carbon intensity and energy cost savings. The results show that the methodology is feasible and can be extended to other cases and greatly contribute to better energy efficiency, reduces peak demand in buildings and increase electric vehicles penetration in transport to workplaces.

Background: Nurses face high levels of stress and work demands, which can affect their work engagement and psychological well-being. Resilience and self-efficacy have been identified as important resources to improve nurses' adaptation and work engagement. Objective: This study aimed to evaluate the mediating role of self-efficacy in the relationship between resilience and stress on work engagement in Peruvian nurses. Methods: A cross-sectional design was used, and data were collected from a sample of 459 nurses. Self-report questionnaires were administered to measure self-efficacy, resilience, stress, and work engagement. SEM analyses were performed to examine the relationship between these variables, and a mediation analysis was conducted to evaluate the role of self-efficacy as a mediator in the relationship between resilience, stress, and work engagement. Results: The results indicated a positive relationship between resilience, self-efficacy, and work engagement, as well as a negative relationship between stress and work engagement. Additionally, self-efficacy mediated the relationship between resilience and work engagement, as well as the relationship between stress and work engagement in nurses. Conclusion: Personal resources such as self-efficacy are a key factor in the relationship between resilience (work resources), stress (work demands), and work engagement of Peruvian nurses. Strengthening self-efficacy and resilience can improve work engagement and personal satisfaction of nurses. Hospital administrators and nursing managers should consider the importance of resilience, stress, work engagement, and self-efficacy in registered nurses and develop effective strategies to improve them. This can have a positive impact on the quality of care provided to patients and on the job satisfaction of nurses.

Obesity is a major public health issue worldwide since it is associated with the development of chronic comorbidities such as type 2 diabetes, dyslipidemias, atherosclerosis, some cancer forms and skin diseases, including psoriasis. Scientific evidence has indicated that the possible link between obesity and psoriasis may be multifactorial, highlighting dietary habits, lifestyle, certain genetic factors and the microbiome as leading factors in the progress of both pathologies because they are associated with a chronic pro-inflammatory state. Thus, inflammation management in obesity is a plausible target for psoriasis, not only because of the sick adipose tissue secretome profile but also due to the relationship of obesity with the rest of the immune derangements associated with psoriasis initiation and maintenance. Hence, this review will provide a general and molecular overview of the relationship between both pathologies and present recent therapeutic advances in treating this problem.

can be emitted by natural and anthropogenic sources. Although efforts have been made to reduce sulfur dioxide emissions worldwide, this pollutant and its adverse effects remain a major concern, especially in developing countries. The aim of this study was the investigated the effects of sulfur dioxide inhalation on human health. This narrative review was done based on the literature published from 2000 to 2022 through PubMed, Springer, Web of Science, Science Direct, and Google Scholar databases. In this study, was done screened first based on the abstract and Final assessment done based on the full text of the article. Finally, 38 articles were selected for inclusion in the study. The results of this study showed that sulfur dioxide has adverse health effects on the human respiratory, cardiovascular, and nervous systems and causes type 2 diabetes and non-accidental deaths. Although some evidence suggests that sulfur dioxide in given concentrations has no adverse health effect, its synergistic effects in combination with other air pollutants may be significant. Among the most important practical results of this study can be mentioned to increase the health awareness of the general public, help the politicians of the health sector in making decisions in the health field, creating awareness among polluting producing units and industries and efforts to reduce the emission of Sulfur dioxide.

STATEMENT OF PROBLEM: Although there are specific and general digital scanning guidelines depending on the system used, it is important to have the necessary flexibility in the acquisition of three-dimensional (3D) images to adapt to any clinical situation without affecting accuracy. PURPOSE: The purpose of this in vitro study was to identify and compare the scanning strategy with the greatest accuracy, in terms of trueness and precision, of four intraoral scanners in the impression of a complete dental arch. MATERIAL AND METHODS: Four digital scanners were evaluated with a 3D measuring software, using a highly accurate reference model obtained from an industrial scanner as a comparator. Four scanning strategies were applied 10 times on a complete maxillary arch cast inside a black methacrylate box. The data were statistically analyzed using one-way analysis of variance (ANOVA) and post hoc comparisons with Tamhane T2 test. RESULTS: The trueness of the Trios and iTero system showed better results with strategy "D," Omnicam with strategy "B," and True Definition with strategy "C". In terms of precision, both iTero and True Definition showed better results with strategy "D", while Trios showed best results with strategy "A" and Omnicam with strategy "B". There were significant differences between the scanning strategies (p<0.05) with the iTero scanner, but not with the other scanners (p>0.05). CONCLUSIONS: The digital impression systems used in the experiment provided sufficient flexibility for the acquisition of 3D images without this affecting the accuracy of the scanner.

Web accessibility means that people with some type of disability can make use of the Web in the same conditions as the rest of the people. When we talk about web accessibility, we refer to a web design and development that allows these people to perceive, understand, navigate and interact with the Web. Web accessibility also benefits other people, including elderly people whose abilities have declined as a result of age. The Web is an essential resource in human activity: education, employment, government, commerce, health, entertainment and many others benefit of the power of the Web. The aim of this systematic literature review is to analyze the empirical methods of evaluating accessibility to educational websites, disabilities and their errors described in a total of 25 selected studies. The results show that in 20 of the 25 papers, web accessibility was evaluated with automatic tools, in 2 papers it was evaluated with real users and in the other 3 papers with automatic tools, real users and experts. There is also evidence that all the educational websites analyzed in the papers need to correct errors. In conclusion, educational websites do not meet any version of the Web Content Accessibility Guidelines (WCAG) and their conformance levels. According to the results, the empirical evaluation methods used for web accessibility could be improved by adopting automatic evaluation tools for website construction and manual mechanisms with web accessibility experts. The challenge for educational institutions is to carry out web accessibility projects to comply with WCAG and other web accessibility standards and current laws of educational inclusion.

Background: The scanner does not measure the dental surface continually. Instead, it generates a point cloud, and these points are then joined to form the scanned object. This approximation will depend on the number of points generated (resolution), which can lead to low accuracy (trueness and precision) when fewer points are obtained. The purpose of this study is to determine the resolution of four intraoral digital imaging systems and to demonstrate the relationship between accuracy and resolution of the intraoral scanner in impressions of a complete dental arch. Material and Methods: A master cast of the complete maxillary arch was prepared with different dental preparations. Using four digital impression systems, the cast was scanned inside of a black methacrylate box, obtaining a total of 40 digital impressions from each scanner. The resolution was obtained by dividing the number of points of each digital impression by the total surface area of the cast. Accuracy was evaluated using a three-dimensional measurement software, using the "best alignment" method of the casts with a highly faithful reference model obtained from an industrial scanner. Pearson correlation was used for statistical analysis of the data. Results: Of the intraoral scanners, Omnicam is the system with the best resolution, with 79.82 points per mm 2 , followed by True Definition with 54.68 points per mm2, Trios with 41.21 points per mm 2 , and iTero with 34.20 points per mm 2 . However, the study found no relationship between resolution and accuracy of the study digital impression systems (P>0.05), except for Omnicam and its precision. Conclusions: The resolution of the digital impression systems has no relationship with the accuracy they achieve in the impression of a complete dental arch. The study found that the Omnicam scanner is the system that obtains the best resolution, and that as the resolution increases, its precision increases.

Pulpal necrosis in permanent teeth that have not completed their root development leads to teeth with a very short root, roots with very thin walls, and an inadequate crown-root ratio, which overshadows their survival prognosis. Currently, there are various therapies to treat immature permanent teeth with pulpal pathology such as the case of apexification. An electronic search was performed in the PubMed database (www.ncbi.nlm.nih.gov), Scopus (www.scopus.com), Cochrane (www.cochrane.org) to identify the clinical investigations related to evolution of the cases. The search of the literature of clinical studies on permanent teeth with open apex that present pulpar pathology and that need treatment, have been found 11 clinical studies of treatments with apexification. The apexification by calcium hydroxide has been applied for many years back to the present as a valid therapy to perform the treatment of apexification.

This review goal is to reflect on the challenges and prospects for water quality in the face of the pandemic caused by the new SARS-CoV-2 coronavirus (COVID-19). Based on the information available so far, the detection of SARS-CoV-2 RNA in wastewater has raised interest in using it as an early warning method, to detect the resurgence of infections and to report the risk associated with contracting SARS-CoV-2 in contact with untreated water or inadequately treated wastewater is discharged. The wastewater-based epidemiological approach can be used as an early indicator of infection within a specific population. On the other hand, it is necessary to collect information from the managers of drinking water supply companies and professionals who are related to water quality, to know SARS-CoV-2 data and information, and its influence on drinking water quality. The basic purpose of this review article is to try to provide a valuable and quick reference guide to COVID-19. Important topics were discussed, such as detection of SARS-CoV-2 in wastewater in various parts of the world; wastewater screening to monitor COVID-19; persistence of SARS-CoV-2 in aquatic systems; the presence of SARS-CoV-2 in drinking water; clean water as a mechanism to deal with the COVID-19 pandemic; chlorine as a disinfectant to eliminate SARS-CoV-2 and damage to ecosystems by the use of chlorine. Currently does not exist extensive literature on the effectiveness of water and wastewater treatment processes that ensure the correct elimination of SARS-CoV-2. Excessive use of disinfectants such as chlorine is causing effects on the environment. This document highlights the need for further research to establish the behavior of the SARS-CoV-2 virus in aquatic systems. This study presents an early overview of the observed and potential impacts of COVID-19 on the environment.

Lifestyle refers to a set of personal and group behaviours related to normative and semantic aspects of social life. Any coherent set of behavioural patterns derived from religious teachings that exist in life can be considered a religious lifestyle. Considering that the dominant religion in Jordan is Islam, the present study focused on the Islamic lifestyle. In addition, given that the correct relationship between couples has been compared to life-giving blood in marriage, and since the quality of marital role plays a determining role, the existence of communication skills in any of the couples can generate satisfaction and compatibility, whereas lack of awareness of these skills could cause misunderstandings and tension. Therefore, the current study aims to study the role of the Islamic lifestyle in communication skills of 250 Muslim couples of Jordan (Amman, Zarqa and Irbid) in 2022. Data were collected using questionnaires during four months, and the validity and reliability was confirmed. In addition, data analysis was performed in Statistical Package for Social Sciences (SPSS) and Linear Structural Relations (LISREL) using mean tests and structural equation modelling. According to the results, Islamic lifestyle had a positive, significant effect on the improvement of communication skills in Muslim couples in Jordan (P-value: 0.76; T-value: 7.92). Therefore, it is recommended that more attention should be paid to this issue by families, researchers and cultural authorities in the country.Contribution: Our findings revealed that Islamic lifestyle improved communication skills in Muslim couples, which demands special attention. By adhering to the Islamic lifestyle, couples can influence each other’s knowledge, emotions, education and growth, and try to have a realistic understanding of each other’s desires, needs, living environment and perceptions that each has in life issues. Furthermore, they can organise their role in the common life in appropriate ways to prevent problems and solve them in the event of problems.

En el Ecuador se busca un proceso de transformación productiva que permita avanzar hacia un mayor crecimiento y equidad, que son tareas que dependen del capital humano de los países, de la capacidad de las personas para resolver nuevos problemas mediante el ejercicio de conocimientos, competencias y habilidades adquiridas que elevan su productividad y su calidad de vida. En la industria de cuero y calzado de la provincia de Tungurahua se necesita elevar la efectividad organizacional de manera tal que contribuya al desarrollo de las estrategias en el cambio de la matriz productiva para lo que lo se plantea como objetivo la medición y gestión del capital intelectual del sector. La investigación es de tipo no experimental, de tipo mixta y de alcance descriptivo – explicativo. Los resultados más relevantes se presentan de acuerdo a la perspectiva de los clientes, empleados y dueños de los negocios.

PURPOSE: Although doxorubicin chemotherapy is commonly applied for treating different malignant tumors, cardiotoxicity induced by this chemotherapeutic agent restricts its clinical use. The use of silymarin/silibinin may mitigate the doxorubicin-induced cardiac adverse effects. For this aim, the potential cardioprotective effects of silymarin/silibinin against the doxorubicin-induced cardiotoxicity were systematically reviewed. METHODS: In this study, we performed a systematic search in accordance with PRISMA guideline for identifying all relevant studies on "the role of silymarin/silibinin against doxorubicin-induced cardiotoxicity" in different electronic databases up to June 2022. Sixty-one articles were obtained and screened based on the predefined inclusion and exclusion criteria. Thirteen eligible papers were finally included in this review. RESULTS: According to the echocardiographic and electrocardiographic findings, the doxorubicin-treated groups presented a significant reduction in ejection fraction, tissue Doppler peak mitral annulus systolic velocity, and fractional shortening as well as bradycardia, prolongation of QT and QRS interval. However, these echocardiographic abnormalities were obviously improved in the silymarin plus doxorubicin groups. As well, the doxorubicin administration led to induce histopathological and biochemical changes in the cardiac cells/tissue; in contrast, the silymarin/silibinin co-administration could mitigate these induced alterations (for most of the cases). CONCLUSION: According to the findings, it was found that the co-administration of silymarin/silibinin alleviates the doxorubicin-induced cardiac adverse effects. Silymarin/silibinin exerts its cardioprotective effects via antioxidant, anti-inflammatory, anti-apoptotic activities, and other mechanisms.

Diabetes mellitus (DM) is considered one of the most massive epidemics of the twenty-first century due to its high mortality rates caused mainly due to its complications; therefore, the early identification of such complications becomes a race against time to establish a prompt diagnosis. The research of complications of DM over the years has allowed the development of numerous alternatives for diagnosis. Among these emerge the quantification of advanced glycation end products (AGEs) given their increased levels due to chronic hyperglycemia, while also being related to the induction of different stress-associated cellular responses and proinflammatory mechanisms involved in the progression of chronic complications of DM. Additionally, the investigation for more valuable and safe techniques has led to developing a newer, noninvasive, and effective tool, termed skin fluorescence (SAF). Hence, this study aimed to establish an update about the molecular mechanisms induced by AGEs during the evolution of chronic complications of DM and describe the newer measurement techniques available, highlighting SAF as a possible tool to measure the risk of developing DM chronic complications.

Conjugated linoleic acids (CLAs) are polyunsaturated fatty acids primarily found in dairy products and ruminant animal products such as beef, lamb, and butter. Supplementation of CLAs has recently become popular among athletes due to the variety of health-promoting effects, including improvements in physical performance. Preclinical and some clinical studies have shown that CLAs can reduce inflammation and oxidative stress and favorably modulate body composition and physical performance; however, the results of previously published clinical trials are mixed. Here, we performed a comprehensive review of previously published clinical trials that assessed the role of CLAs in modulating inflammation, oxidative stress, body composition, and select indices of physical performance, emphasizing the molecular mechanisms governing these changes. The findings of our review demonstrate that the effect of supplementation with CLAs on inflammation and oxidative stress is controversial, but this supplement can decrease body fat mass and increase physical performance. Future well-designed randomized clinical trials are warranted to determine the effectiveness of (1) specific doses of CLAs; (2) different dosing durations of CLAs; (3) various CLA isomers, and the exact molecular mechanisms by which CLAs positively influence oxidative stress, inflammation, body composition, and physical performance.

El mundo día a día se beneficia de la tecnología que trae una serie de ventajas, sobre todo en el ámbito educativo donde ha revolucionado la forma de enseñar, así como de aprender, hoy más que nunca necesitamos de ella para acceder a la educación en tiempos de pandemia, donde los estudiantes se ven impedidos para acudir a los establecimientos educativos debido a la cuarentena, esto hace que tanto estudiantes como docentes busquen formas de superar las brechas digitales para así poder acceder a una educación de calidad y calidez, es por eso que este ensayo le da mucho valor al docente que a pesar de ser inmigrante tecnológico se capacita para convertir la tecnología en una verdadera herramienta al servicio de la educación, para ello se presentan algunos ideas de cómo utilizar de la mejor manera los medios digitales para superar barreras que impidan el aprendizaje de los estudiantes y la correcta enseñanza por parte de los docentes.

The bulk chlorine decay rate in drinking water supply systems depend on many factors, including temperature. In this document, the method to determine the order of reaction of chlorine with water is reported, as well as the method to estimate Kb (Bulk reaction rate constant). Experiments were carried out to determine the bulk chlorine decay, for which a set of water samples to determine the free residual chlorine every hour were analyzed. Chlorine concentrations were graphed against time and adjusted appropriately to the developed model. The experimental results showed that the average value of the mass decomposition rate was 0.15 h−1. It was shown that temperature affects the variation of the reaction rate of chlorine with water, Kb increases as temperature increases. In this manuscript it is reported:•The method that allows determining the reaction kinetic order of chlorine with drinking water.•The method that can help residual chlorine modelers in the correct definition of the bulk reaction rate constant.•The effectiveness of the method for evaluating the decomposition of residual chlorine in drinking water distribution networks as a function of temperature.

The application of ornamental plants in constructed wetlands (CW) is increasingly of interest to researchers, professionals actively involved in wetland management and/or wastewater treatment (WWT), so it is necessary to know the trends in this field of research. The objective of this study was to develop a scientometric study on the use of ornamental plants in CWs for the WWT during the period 2002–2022. For this, a search of the information was carried out in the Scopus database, including all the articles and reviews related to this field. The analysis of the recovered documents allowed to know key aspects of the evolution of production in recent years, the maturity of research in this field, identify the most used ornamental plants and therefore identify gaps. Likewise, it was possible to identify the countries, the most relevant authors, the main journals and the most cited articles through which knowledge in this area is disseminated. The results showed that Mexico, Brazil, USA, China and India have the highest number of publications related to the use of ornamental plants in the CWs. It was found that the most used ornamental plants are Canna, Iris, Heliconia and Zantedeschia. This analysis can help researchers to identify new research approaches in this field. It is concluded that this field of knowledge has aroused great interest since 2002; however, more research can still be carried out on the application of CWs with ornamental plants in cold climates, the influence of the substrate on the growth of these plants.

This research presents a completely decarbonized system structured with renewable energies for the fragile ecosystem of the Galapagos Islands of Ecuador, with a horizon to the year 2050. The transition process begins with clear legal actions and allocating economic resources that clearly promote a change in the energy matrix and the transition would be achieved until the year 2050. The Galapagos Islands are the second largest marine reserve on the planet, declared a World Heritage Site in 1978 for UNESCO. The archipelago, a beautiful ecological attraction, has tourism as its main economic source. The biggest problem is in the supply of energy that mainly comes from fossil fuels, in addition to that, the smell of fuel in several places is out of tune with the harmonious nature and its species. The efforts began to be noticed when in the Archipelago the new implementations of renewable energy began to become a reality with the purpose of stopping using fossil fuels. In this sense, there is the potential to take advantage of the resources available in specific sites, especially the photovoltaic and wind solar considered in the National Plan All a Life. The change in the productive matrix from the national level also implies a change in demand, including at the transportation level with the use of electric vehicles and the use of electric stoves in homes. The purpose is that energy services in the Galapagos Islands progressively increase, on the one hand, replacing fossil fuels and on the other, supplying the growing demand with a view to 2050, taking advantage of renewable energies until reaching 100%.