CODAPACK3D. A new version of Compositional Data Package

The statistical analysis of compositional data should be treated using logratios of parts,which are difficult to use correctly in standard statistical packages. For this reason afreeware package, named CoDaPack was created. This software implements most of thebasic statistical methods suitable for compositional data.In this paper we describe the new version of the package that now is calledCoDaPack3D. It is developed in Visual Basic for applications (associated with Excel©),Visual Basic and Open GL, and it is oriented towards users with a minimum knowledgeof computers with the aim at being simple and easy to use.This new version includes new graphical output in 2D and 3D. These outputs could bezoomed and, in 3D, rotated. Also a customization menu is included and outputs couldbe saved in jpeg format. Also this new version includes an interactive help and alldialog windows have been improved in order to facilitate its use.To use CoDaPack one has to access Excel© and introduce the data in a standardspreadsheet. These should be organized as a matrix where Excel© rows correspond tothe observations and columns to the parts. The user executes macros that returnnumerical or graphical results. There are two kinds of numerical results: new variablesand descriptive statistics, and both appear on the same sheet. Graphical output appearsin independent windows. In the present version there are 8 menus, with a total of 38submenus which, after some dialogue, directly call the corresponding macro. Thedialogues ask the user to input variables and further parameters needed, as well aswhere to put these results. The web site http://ima.udg.es/CoDaPack contains thisfreeware package and only Microsoft Excel© under Microsoft Windows© is required torun the software.Kew words: Compositional data Analysis, Software

Assessment and reuse of contents in the competence-based educational platform InterMediActor

This paper describes a failure alert system and a methodology for content reuse in a new instructional design system called InterMediActor (IMA). IMA provides an environment for instructional content design, production and reuse, and for students’ evaluation based in content specification through a hierarchical structure of competences. The student assessment process and information extraction process for content reuse are explained.

Systems medicine and integrated care to combat chronic noncommunicable diseases

We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems.

Percepción del dolor en pacientes postoperados de cirugía cardiaca

Pain is defined as an unpleasant sensory or emotional experience, associated with tissue damage, that is a reality linked to the surgical procedure and the postoperative period. Objective: Knowing the degree of pain experienced by patients after cardiac surgery, depending on the type of intervention they underwent, over the post-operative period in an intensive care unit (ICU). Method: Descriptive observational study. Pain was assessed by the visual analog scale (VAS), going from 0 to 10, thereby obtaining the first VAS1 assessment at 2 h post-extubation and every 8 hours thereafter up to 48 hours or until discharge to floor VAS7. It included patients having undergone cardiac surgery [valve surgery, bypass, combined procedure (including valve surgery and bypass) and mediastinitis]. Data were processed using Spss.v 20. Results: 120 patients 70 years old on average (standard deviation (SD): 13.3 years old) were included, out of which 70% were male. 40.8% of them had underwent bypass coronary revascularization. Patients subjected to the bypass technique showed an VAS1 mean value of 4.35 (SD: 2.45), unlike those subjected to valve surgery, who showed a mean value of 2.89 (SD: 2.27), those subjected to the combined procedure, who showed a mean value of 3.87 (SD: 2.90), and those with mediastinitis, who showed a mean value of 3.33 (SD: 3.51); (p < 0.031). 28.5% of patients had underwent revascularization (n = 49 ) by an internal mam mary artery (IMA) graft. These patients showed a mean value for VAS1 of 5.4 (SD: 1.89), unlike those who had underwent a combined procedure [IMA and saphenous vein (SV)], who showed a mean value of 3.9 (SD: 2.6), and those who had underwent a SV procedure , who showed a mean value of 3.5 (SD: 2.1); (p < 0.045). Conclusions: Patients having underwent bypass and IMA procedures perceive more pain than in other cardiac surgery and graft interventions