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Wheat is one of the most important crops worldwide. Mexicali, Baja California, is an important wheat producer in Mexico with an average production of 507,543 t. Wheat straw is generated as a residue which could be used for different purposes such as bioenergy, heat and power generation. In this work, an assessment and potential site determination of a biomass power plant operating with wheat straw as fuel was performed. Aspen Plus was used to evaluate a plant capacity of at least 10 MW considering the physicochemical properties and an higher heating value of 14.86 MJ kg-1 of the wheat straw from the region. The combustion produced 39.76 MW, and the overall plant efficiency was 25.52%. The development of the multi-criteria geographic information system model allowed us to assess and analyse four factors and three restrictions to determine the potential site for the biomass power plant. The factors were raw material, wheat crops, electric transmission lines, paths and roads, water canals and aqueducts, while the restrictions were localities, Ramsar sites and faults. The biomass power plant is technically and geographically feasible. The geographical coordinates of the potential site of the biomass power plant that fulfils all the criteria are 32°29'29.72″N and 115°15'39.45″W.

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RESUMEN Introducción: En la valoración de dificultad para realizar la laringoscopia convencional no se realza la integración necesaria de aspectos clínicos esenciales relacionados con el control respiratorio. Objetivo: Validar un modelo de predicción de una laringoscopia anatómicamente difícil en el paciente que requiere de intubación orotraqueal. Método: Se realizó un estudio analítico en una población de 17 966 pacientes con necesidad de laringoscopia directa para una intubación orotraqueal con fines quirúrgicos en el Hospital General Docente "Dr. Agostinho Neto" de Guantánamo entre el 2015 y el 2018. Se determinó por muestreo aleatorizado una muestra de 17 068 pacientes. Se estudiaron las siguientes variables: estigma periférico para laringoscopia difícil, laringoscopia difícil pos-inducción anestésico, evaluación laringoscópica según Cormack-Lehane, valor diagnóstico del modelo de evaluación predictiva para laringoscopia. Resultados: Los altos grados en la clasificación de aspectos clínicos predictivos y la coexistencia con la alteración morfológica de la epiglotis fueron los marcadores más asociados con la probabilidad de laringoscopia anatómicamente difícil. Con la integración de cuatros aspectos clínicos esenciales se identificó el grado de dificultad probable para visualizar las cuerdas vocales. Conclusiones: Se diseñó un modelo que posibilitó la predicción de una laringoscopia anatómicamente difícil, cuya validación certificó su viabilidad para aplicarlo en la práctica médica.

ABSTRACT Introduction: In assessing the difficulty of performing conventional laryngoscopy, the necessary integration of essential clinical aspects related to respiratory control is not enhanced. Objective: To validate a prediction model of an anatomically difficult laryngoscopy in the patient that requires orotracheal intubation. Method: An analytical study was carried out in a population of 17,966 patients in need of direct laryngoscopy for an orotracheal intubation for surgical purposes at the General Teaching Hospital "Dr. Agostinho Neto" from Guantanamo between 2015 and 2018. A sample of 17,068 patients was determined by randomized sampling. The following variables were studied: peripheral stigma for difficult laryngoscopy, difficult laryngoscopy after anesthetic induction, laryngoscopic evaluation according to Cormack-Lehane, diagnostic value of the predictive evaluation model for laryngoscopy. Results: The high degrees in the classification of predictive clinical aspects and the coexistence with the morphological alteration of the epiglottis were the markers most associated with the probability of anatomically difficult laryngoscopy. With the integration of four essential clinical aspects, the degree of probable difficulty in visualizing the vocal cords was identified. Conclusions: A model was designed that allowed the prediction of an anatomically difficult laryngoscopy, whose validation certified its feasibility to apply it in medical practice.

RESUMO Introdução: Na avaliação da dificuldade na realização da laringoscopia convencional, a integração necessária dos aspectos clínicos essenciais relacionados ao controle respiratório não é aprimorada. Objetivo: Validar um modelo de previsão de uma laringoscopia anatomicamente difícil no paciente que necessita de intubação orotraqueal. Método: Foi realizado um estudo analítico em uma população de 17.966 pacientes com necessidade de laringoscopia direta para intubação orotraqueal para fins cirúrgicos no Hospital Geral de Ensino "Dr. Agostinho Neto" de Guantánamo entre 2015 e 2018. Uma amostra de 17.068 pacientes foi determinada por amostragem aleatória. Foram estudadas as seguintes variáveis: estigma periférico para laringoscopia difícil, laringoscopia difícil após indução anestésica, avaliação laringoscópica segundo Cormack-Lehane, valor diagnóstico do modelo de avaliação preditiva para laringoscopia. Resultados: Os altos graus na classificação dos aspectos clínicos preditivos e a coexistência com a alteração morfológica da epiglote foram os marcadores mais associados à probabilidade de laringoscopia anatomicamente difícil. Com a integração de quatro aspectos clínicos essenciais, foi identificado o grau de provável dificuldade na visualização das cordas vocais. Conclusões: Foi elaborado um modelo que permitia prever uma laringoscopia anatomicamente difícil, cuja validação atestava sua viabilidade de aplicá-la na prática médica.

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CONTEXT: The Unified Model of Information Systems Continuance (UMISC) is a metamodel for the evaluation of clinical information systems (CISs) that integrates constructs from five models that have previously been published in the literature. UMISC was developed at the Georges Pompidou University Hospital (HEGP) in Paris and was partially validated at the Saint Joseph Hospital Group (HPSJ), another acute care institution using the same CIS as HEGP. OBJECTIVE: The aim of this replication study was twofold: (1) to perform an external validation of UMISC in two different hospitals and country contexts: the Italian Hospital of Buenos Aires (HIBA) in Argentina and the Hospital Sirio Libanes in Sao Paulo, Brazil (HSL); (2) to compare, using the same evaluation model, the determinants of satisfaction, use, and continuance intention observed at HIBA and HSL with those previously observed at HEGP and HPSJ. METHODS: The UMISC evaluation questionnaires were translated from their original languages (English and French) to Brazilian Portuguese and Spanish following the translation/back-translation method. These questionnaires were then applied at each target site. The 21 UMISC-associated hypotheses were tested using structural equation modeling (SEM). RESULTS: A total of 3020 users, 1079 at HIBA and 1941 at the HSL, were included in the analysis. The respondents included 1406 medical staff and 1001 nursing staff. The average profession-adjusted use, overall satisfaction and continuance intention were significantly higher at HIBA than at HSL in the medical and nursing groups. In SEM analysis, UMISC explained 23% and 11% of the CIS use dimension, 72% and 85% of health professionals' satisfaction, and 41% and 60% of continuance intention at HIBA and HSL, respectively. Twenty of the 21 UMISC-related hypotheses were validated in at least one of the four evaluation sites, and 16 were validated in two or more sites. CONCLUSION: The UMISC evaluation metamodel appears to be a robust comparison and explanatory model of satisfaction, use and continuance intention for CISs in late post adoption situations.

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Introducción: En los últimos años se ha destacado la importancia de la evaluación en la educación médica para la mejora de la calidad educativa. Objetivo: Diseñar un modelo teórico de evaluación para la estrategia curricular de Medicina Natural y Tradicional de la carrera de Medicina. Métodos: Se realizó una investigación de desarrollo en la Facultad de Ciencias Médicas Enrique Cabrera durante el curso 2015-2016, y se utilizaron los métodos de nivel teórico: el Histórico lógico, la sistematización y la modelación, y de nivel empírico, la revisión documental y el criterio de expertos, lo que permitió evidenciar los resultados de la aplicación de la estrategia curricular de Medicina Natural y Tradicional en la formación de los estudiantes de la carrera de Medicina desde las exigencias de la Educación Médica cubana actual. Resultados: Se definieron las características y principios en el modelo propuesto, se sustentaron los fundamentos desde las ciencias de la educación médica. El modelo posee carácter sistémico, flexible, permite ser modificado en función de la solución de problemas ante las necesidades de la sociedad. Se valida teóricamente por un grupo de expertos. Conclusiones: Se diseña el modelo teórico de evaluación de la estrategia curricular de Medicina Natural y Tradicional para la formación de los estudiantes en la carrera de Medicina, posibilita identificar las relaciones que se establecen entre la evaluación curricular y la aplicación de las estrategias, en particular los resultados que se alcanzan después de la aplicación del modelo teórico que enriquecen las Ciencias de la Educación Médica(AU)

Introduction: In the last years, the importance of evaluation in medical education has been highlighted for the improvement of educational. Objective: To design a theoretical model of evaluation for the curricular strategy of Natural and Traditional Medicine of the medical major. Methods: A development research was carried out at Enrique Cabrera Medical School during the academic year 2015-2016. We used theoretical methods such as the logical-historic method, systematization and modelling, and empirical methods such as document review and experts' criterion, which allowed to demonstrate the results of the application of the curricular strategy of Natural and Traditional Medicine in the training of medial students considering the demands of Cuban current medical education. Results: We defined the characteristics and principles in the proposed model and credited the foundations as based on the medical education sciences. The model has a systemic and flexible character, can be modified depending on the solution of problems in view of the societal needs. It was validated theoretically by a group of experts. Conclusions: The theoretical model for the evaluation of the curricular strategy of Natural and Traditional Medicine for the training of students in the medical major is designed, and makes it possible to identify the relationships established between curricular evaluation and the application of the strategies, in particular the outcomes reached after the application of the theoretical model that enrich medical education sciences(AU)

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Resumen Este artículo tiene por objeto proponer un modelo procedimental diseñado para optimizar la experiencia de la ciudadanía en la toma de decisiones de las políticas públicas a través de la ludificación. Se parte de la consideración que la ludificación promueve la motivación hacia una actividad prolongando su participación dentro de un ámbito específico. En este caso, se encamina su aplicación para motivar la integración de los ciudadanos en la toma de decisiones. Para ello se contrastan tres modelos de evaluación de políticas públicas que incorporan la participación civil en tres roles diferentes: auditor, pasivo y activo. Al aplicar la metodología Delphi, los resultados de fiabilidad y consistencia interna demuestran que el modelo de participación activa tiene mayor valoración por parte de los expertos respecto a la ludificación, Como conclusión, el modelo generado abre una nueva área de conocimiento dentro de la evaluación de políticas públicas imbuida en la interactividad del contexto mediático.

Resumo Este artigo tem como objetivo propor um modelo procedimental concebido para otimizar a experiência dos cidadãos na tomada de decisões de políticas públicas por meio da gamificação. Parte-se do pressuposto de que a gamificação promove a motivação para uma atividade, aumentando a participação dentro de um âmbito específico. Nesse caso, a gamificação é utilizada para incentivar o envolvimento dos cidadãos na tomada de decisões. Com esse objetivo, comparam-se três modelos de avaliação de políticas públicas que incorporam a participação civil em três papéis diferentes: auditor, passiva e ativa. Ao aplicar a metodologia Delphi, os resultados de fidelidade e consistência interna revelam que o modelo de participação ativa é alvo de uma valoração superior por parte dos especialistas, no que se refere à gamificação. Em conclusão, o modelo gerado abre uma nova área de conhecimento no âmbito da avaliação de políticas públicas, integrada na interatividade do contexto midiático

Abstract This article proposes a procedural model designed to optimize the experience of citizens in decision making of public policies through gamification. The study assumes that gamification increases motivation and contributes to increase involvement within a specific area. In this case, gamification is used to encourage citizens' engagement in decision-making, based on three models of evaluation of public policies that incorporate civil participation in three different roles: auditor, passive and active. After applying the Delphi methodology, the results of reliability and internal consistency show that experts attribute a higher value to the model of active participation using gamification. In conclusion, the model designed opens a new area of knowledge within the evaluation of public policies, embedded in the interactivity of the media context.

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