Herramienta de coordinación de titulaciones en la E.P.S. Linares

En este trabajo se presenta una plataforma de coordinación de actividades vinculadas con la docencia de todas las asignaturas de las titulaciones de grado y máster impartidas en el centro, organizadas por cursos y títulos, de manera que el profesorado de cada asignatura cuente, para la programación sus tareas (pruebas, entregas de prácticas o relaciones de problemas, visitas, conferencias, seminarios, etc.), de toda la información sobre el resto de asignaturas del título. En este sentido, la plataforma se nutre de la información que el profesorado, usuario principal de la misma, introduce en ella. Debe contener las actividades del trabajo y recursos utilizados: es decir, metodologías, técnicas y tecnología

Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Structure of Fe–Ni and Fe–Ni–S molten alloys by neutron diffraction

International audienceThe static S(Q) liquid structure factors for binary FexNi100−x, x = 90 and 85 and ternary Fe85Ni5S10 molten alloys are investigated by means of the concurrent use of neutron diffraction and Reverse Monte Carlo simulations. The measured g(r) radial distributions reveal atomic orderings varying from that present in the Fe90Ni10 alloy, reminiscent of the ideal b.c.c. structure of solid Fe, to a far more open structure found in Fe85Ni5S10. From data at hand no clear evidence of clustering of sulphur within the Fe–Ni matrix is found but, in contrast, its addition leads to significant changes in structural properties manifested by the loss of the intermediate range order

Metalloenzyme-like catalyzed isomerizations of sugars by Lewis acid zeolites

Isomerization of sugars is used in a variety of industrially relevant processes and in glycolysis. Here, we show that hydrophobic zeolite beta with framework tin or titanium Lewis acid centers isomerizes sugars, e.g., glucose, via reaction pathways that are analogous to those of metalloenzymes. Specifically, experimental and theoretical investigations reveal that glucose partitions into the zeolite in the pyranose form, ring opens to the acyclic form in the presence of the Lewis acid center, isomerizes into the acyclic form of fructose, and finally ring closes to yield the furanose product. The zeolite catalysts provide processing advantages over metalloenzymes such as an ability to work at higher temperatures and in acidic conditions that allow for the isomerization reaction to be coupled with other important conversions

Genetic diversity and structure in Criolla Negra goats in Queretaro, Mexico

Since their introduction to Mexico goats have undergone a long process of adaptation and selection, resulting in highly rustic local animals. However, importation of improved breeds has led to the extinction of some regional breeds. For example, the Criolla Negra goat breed is known for its rusticity and high milk quality, but is in decline. A genetic characterization was done of a Criolla Negra population. Hair samples were collected in three goat herds located in different municipalities of the state of Querétaro, Mexico: Cadereyta de Montes (n= 7); El Marqués (n= 11); and San Juan del Río (n= 27). Thirty microsatellites were used to quantify the number of alleles per marker (NA), median number of alleles (MNA), number of effective alleles (NEA), observed heterozygosis (Ho), expected heterozygosis (He), polymorphic data content (PDC), the fixation index (FIS) and Hardy Weinberg equilibrium (HWE). The Criolla Negra population was compared to thirteen breeds forming part of the BioGoat project. Genetic diversity was found to be high in this population. A total of 243 alleles were identified with an MNA of 8.1 alleles per marker. The markers were informative (PDC= 0.06) for polymorphism. The He (0.71) and Ho (0.62) values indicate a slight imbalance in the population. Reynolds genetic distance results showed the Criolla Negra breed to be genetically furthest from the Anglonubia breed and nearest the Murciano-Granadina breed. The studied Criolla Negra goat population exhibits a breed structure well differentiated from the other breeds in the analysis

Joint status in Spanish haemophilia B patients assessed using the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) score

Aim: The use of musculoskeletal ultrasound (MSK-US) following protocols for haemophilic arthropathy and the Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) score can help standardize monitoring in haemophilia. This study evaluated the joint status (elbows, knees and ankles) of patients with haemophilia B (HB) in Spain using MSK-US and the HEAD-US score. Methods: Haemophilia B patients 6514&nbsp;years old were included in this observational, multicentre, cross-sectional study, regardless of their clinical condition, HB severity and treatment received. Two blinded observers were involved in image acquisition and scoring in each centre. Results: Eighty-two patients from 12 centres were enrolled: 27% mild HB, 23% moderate, 50% severe HB. Mean age was 38.9&nbsp;\ub1&nbsp;16.4&nbsp;years, 60% were treated on demand (OD) and 40% were on prophylaxis. HEAD-US was zero in all joints in 28.6% OD patients and 36.4% on prophylaxis. Mean scores significantly worsened with HB severity, except for the left knee. Patients on primary and secondary prophylaxis had significantly better joint health vs OD patients in all joints, except the right ankle. Among OD patients, those with severe disease presented significantly worse scores in all HEAD-US items related to permanent damage. Conclusion: Joint status of HB patients in Spain is influenced by severity and treatment modality, related to the development of arthropathy, which appears prevalent in OD patients with severe HB. Routine assessment with an imaging tool such as ultrasound and HEAD-US system may help to improve joint health by personalizing and adjusting treatment in this population

A decade of changes in management of immune thrombocytopenia, with special focus on elderly patients

[Background]: Ten years after their availability, thrombopoietin receptor agonists (TPO-RA) have heralded a paradigm shift in the treatment of immune thrombocytopenia (ITP). This study was aimed to analyze the implementation of current recommendations in the standard practice of adult ITP patients, and how age may influence those changes.[Methods]: We included 121 adult patients (> 65 years, n = 54; younger individuals, n = 67) who initiated treatment with TPO-RA between January 2012 and December 2014.[Results]: Patients older than 65 years treated with TPO-RA presented at diagnosis with significantly higher platelet counts, less bleeding, and a more prothrombotic profile than younger ones. The high efficacy rates of TPO-RA, preferentially used during the last decade in non-chronic phases, precluded from further therapies in the majority of ITP patients. Their administration was associated with a sharp decline in the last decade in the use of splenectomy and intravenous immunoglobulin, especially in younger ITP individuals.[Conclusion]: These results confirm (1) that there is a preferential use of TPO-RAs in elderly ITP patients with fewer bleeding complications but more unfavorable prothrombotic conditions than in younger individuals, and (2) that early use of these agents has been established as an effective therapeutic alternative to other second line therapies.This work was supported by Amgen S.A. Spain