University of Azuay

This article presents the optimization of the autonomy of the Dayan Chock C1 electric vehicle through the design of lithium-based batteries. First, the battery components are characterized, and areas for improvement in the original battery system are identified. The results obtained from this proposal are validated through dynamic tests conducted on established routes in Quito-Tumbaco, $(2850 \mathrm{~m}$ to 2355 m of altitude) Both the application and functionality of the electric vehicle are evaluated based on its weight and range under real-life driving conditions. This work contributes to the development of more efficient electric vehicles with greater range, which could have a significant impact on the sustainable transportation industry.

Integrated health management represents a pivotal strategy for enhancing both operational efficiency and the quality of care in hospital environments. This study undertakes a systematic literature review to examine the influence of integrated health management on hospital administration. The principal aim is to synthesise a structured body of knowledge capable of informing strategic clinical decision-making and shaping future research trajectories. This investigation employed the Constructivist Knowledge Development Process (ProKnow-C), a methodological framework implemented in four sequential stages: (i) the selection of pertinent peer-reviewed literature to construct a representative portfolio; (ii) bibliometric analysis to evaluate the impact and consistency of sources; (iii) systemic analysis to categorise thematic dimensions; and (iv) the identification of research gaps and prospective avenues for investigation. A total of 20 scholarly articles were scrutinised using both quantitative and qualitative criteria. Three principal approaches to integrated hospital management were identified: (1) the utilisation of management tools-such as the Balanced Scorecard and performance indicators-to improve service delivery efficiency; (2) strategies for performance enhancement, underpinned by strategic planning, detailed operational analysis, and robust internal controls; and (3) financial management approaches, grounded in hospital information systems and evidence-based decision-making. Bibliometric findings confirmed the internal coherence of the selected portfolio, while the systemic analysis demonstrated the presence of shared conceptual frameworks throughout the literature. This systematic review contributed to the consolidation of a structured knowledge base concerning integrated hospital management and highlighted critical areas for future research. Further enquiry is warranted into models for clinical risk mitigation, the optimisation of resource allocation, and the development of financially viable management practices. The ProKnow-C methodology proved robust and suitable for guiding research within the domains of clinical evaluation and healthcare management.

Landslides are hazardous events that occur mainly in mountainous areas and cause substantial losses of various kinds worldwide; therefore, it is important to investigate them. In this study, a specific Machine Learning (ML) method was further analyzed due to the good results obtained in the previous stage of this research. The algorithm implemented is Extreme Gradient Boosting (XGBoost), which was used to evaluate the susceptibility to landslides recorded in the city of Cuenca (Ecuador) and its surroundings, generating the respective Landslide Susceptibility Maps (LSM). For the model implementation, a landslide inventory updated to 2019 was used and several sets from 15 available conditioning factors were considered, applying two different methods of random point sampling. Additionally, a hyperparameter tuning process of XGBoost has been employed in order to optimize the predictive and computational performance of each model. The results obtained were validated using AUC-ROC, F-Score and the degree of landslide coincidence adjustment at high and very high susceptibility levels, showing a good predictive capacity in most cases. The best results were obtained with the set of the six best conditioning factors previously determined, as it produced good values in validation metrics (AUC = 0.83; F-Score = 0.73) and a degree of coincidence of landslides in the high and very high susceptibility levels above 90%. The Wilcoxon text led to establishing significant differences between methods. These results show the need to perform susceptibility analyses with different data sets to determine the most appropriate ones.

La justicia constitucional, como institución de defensa jurisdiccional de la Constitución frente a actos del poder público y de particulares en determinados supuestos, tiene su origen y evolución en contextos diferentes, tanto en América como en Europa. De cualquier manera, la configuración y expansión del modelo de revisión judicial de constitucionalidad que se adopte, así como, el marco de atribuciones y competencias asignadas al órgano encargado de la guarda constitucional, dependen de un concepto mismo de Constitución.

IntroductionHemorrhage is a major cause of preventable trauma deaths, and the ABC approach is widely used during the primary survey. We hypothesize that prioritizing circulation over intubation (CAB) can improve outcomes in patients with exsanguinating injuries.MethodsA prospective observational study involving international trauma centers was conducted. Patients with systolic blood pressure below 90 who were intubated within 30 min of arrival were included. Prioritizing circulation (CAB) was defined as delaying intubation until blood products were started, and/or bleeding control was performed before securing the airway. Demographics, clinical data, and outcomes were recorded.ResultsThe study included 278 eligible patients, with 61.5% falling within the “CAB” cohort and 38.5% in the “ABC” cohort. Demographic and disease characteristics, including age, sex, ISS, use of blood products, and other relevant factors, exhibited comparable distributions between the two cohorts. The CAB group had a higher proportion of penetrating injuries and more patients receiving intubation in the operating room. Notably, patients in the CAB group demonstrated higher GCS scores, lower SBP values before intubation but higher after intubation, and a significantly lower incidence of cardiac arrest and post-intubation hypotension. Key outcomes revealed significantly lower 24-hour mortality in the CAB group (11.1% vs. 69.2%), a lower rate of renal failure, and a higher rate of ARDS. Multivariable logistic regression models showed a 91% reduction in the odds of mortality within 24 h and an 89% reduction at 30 days for the CAB cohort compared to the ABC cohort. These findings suggest that prioritizing circulation before intubation is associated with improved outcomes in patients with exsanguinating injuries.ConclusionPost-intubation hypotension is observed to be correlated with worse outcomes. The consideration of prioritizing circulation over intubation in patients with exsanguinating injuries, allowing for resuscitation, or bleeding control, appears to be associated with potential improvements in survival. Emphasizing the importance of circulation and resuscitation is crucial, and this approach might offer benefits for various bleeding-related conditions.

La investigación realizada se centró en llevar a cabo una revisión sistemática de la literatura, explorando diversas bases de datos académicas para analizar la relación entre el trastorno por déficit de atención e hiperactividad (TDAH) en niños y su comprensión lectora. Los hallazgos revelaron que el TDAH tiene un impacto significativo en las dificultades de comprensión lectora. La metodología empleada se basó en la revisión sistemática de literatura científica. Como resultado de este estudio, se concluyó que las dificultades en la comprensión lectora de niños con TDAH están relacionadas con problemas sintácticos, retención de ideas y oraciones. Además, se identificó que las causas de estas dificultades son de naturaleza multifactorial, involucrando factores cognitivos y conductuales. Finalmente, se observó que España, Estados Unidos y Colombia son los países con mayor cantidad de investigaciones sobre la comprensión lectora en niños con TDAH.

Phenethyl isothiocyanate (PEITC), a compound derived from cruciferous vegetables, has garnered attention for its anticancer properties. This review synthesizes existing research on PEITC, focusing on its mechanisms of action in combatting cancer. PEITC has been found to be effective against various cancer types, such as breast, prostate, lung, colon, and pancreatic cancers. Its anticancer activities are mediated through several mechanisms, including the induction of apoptosis (programmed cell death), inhibition of cell proliferation, suppression of angiogenesis (formation of new blood vessels that feed tumors), and reduction of metastasis (spread of cancer cells to new areas). PEITC targets crucial cellular signaling pathways involved in cancer progression, notably the Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB), Protein Kinase B (Akt), and Mitogen-Activated Protein Kinase (MAPK) pathways. These findings suggest PEITC's potential as a therapeutic agent against cancer. However, further research is necessary to determine the optimal dosage, understand its bioavailability, and assess potential side effects. This will be crucial for developing PEITC-based treatments that are both effective and safe for clinical use in cancer therapy.

Introducción: Los intentos de suicidio han aumentado entre la población joven, convirtiéndose ya en un problema de salud pública, y tienen importantes implicaciones individuales, familiares y sociales. El objetivo de este estudio fue establecer la relación entre ciertas variables culturales y el funcionamiento familiar en jóvenes con y sin intento de suicidio en Ecuador. Método e instrumentos: El presente fue un estudio de casos y controles. Se aplicó la Entrevista Neuropsiquiátrica Internacional para adolescentes y adultos, la Escala de Intención Suicida de Pierce, la Batería de Cuestionarios de Variables Multidimensionales Culturales, el FACE III y el FF-SIL, todos estos adaptados y validados culturalmente al contexto ecuatoriano. Para el análisis estadístico se realizó la prueba de comparación de medias entre dos grupos U de Mann-Whitney y el coeficiente de correlación rho de Spearman. Resultados: Se encontraron diferencias significativas en torno a la variable cultural independencia entre casos y controles (p > 0.05). En relación al funcionamiento familiar, los jóvenes que intentaron suicidarse pertenecían a familias disfuncionales. Discusión: Los patrones culturales influyen en el intento de suicidio en los jóvenes; sin embargo, el funcionamiento familiar, caracterizado por dificultades en la adaptación y una escasa cohesión, es un factor de riesgo para que se produzca la tentativa suicida. Recibido: 09/09/2022 Aceptado: 25/09/2023

Virtual reality (VR) environments have gained significant attention in therapeutic use cases as a tool for generating controlled and immersive experiences. However, to ensure the effectiveness of the VR application, maintaining a high quality of experience (QoE) is critical. In QoE-sensitive VR environments, even a minor degradation or impairment can significantly impact user presence, engagement, and attention. This study presents an experimental analysis of the influence of network factors on QoE. We conduct the research using a VR-based mindfulness scenario over an 802.11ax network as an example of a QoE-sensitive VR environment, that has been applied to a sample population of 60 individuals. Our results demonstrate that QoE degradation in 2.4 GHz networks is primarily attributed to traffic, while in 5 GHz networks, it is primarily influenced by the signal strength captured by the VR device. These findings, among others, provide valuable insights for guiding the design of VR systems and optimizing network configurations to deliver an enhanced QoE.