Implementación de una plataforma en la nube para los Cursos Masivos Abiertos en Línea (MOOC) utilizando Google Course Builder e infraestructuras de escritorio virtual.

El objetivo fue la implantación de una plataforma en la nube para los Cursos Masivos Abiertos en Línea (MOOC) utilizando Google Course Builder e Infraestructuras de Escritorio Virtual, mediante esta infraestructura se publicó un curso en línea sobre la asignatura de Sistemas Operativos dictada en la Escuela de Ingeniería en Sistemas de la Facultad de Informática y Electrónica de la Escuela Superior Politécnica de Chimborazo. Se desarrolló una solución tecnológica, utilizando modelos y servicios de la computación en la nube, que consiguió recrear uno de los retos importantes de las soluciones e-learning, como son los laboratorios de computación. El diseño de la solución está compuesto por un conjunto de herramientas de tipo abierto, que emplea los tres servicios en la nube como son: Infraestructura como Servicio (IaaS) para brindar escritorios virtuales (VDI) utilizando OpenUDS, Plataforma como servicio (PaaS) para publicar los cursos masivos en línea con Google Course Builder (GCB) y Software como Servicio (SaaS) para brindar un conjunto de aplicaciones disponibles en la Red. Este proceso de desarrollo y despliegue fue guiado por la metodología SCRUM, que permitió cumplir con los requerimientos establecidos por el usuario, tiempos y entregables generados en cada iteración. La implantación de estos servicios consiguió un grado de aceptación del 90%, obteniendo similares beneficios a los que se logran mediante los laboratorios físicos de las instituciones educativas. Las integraciones de los servicios en la nube son propicias para la creación de escenarios e-learning con laboratorios virtuales de computación, que apoyen el desarrollo práctico de una clase. Se recomienda el uso de esta solución a las unidades educativas, ya que los estudiantes tienen acceso a un sinnúmero de aplicaciones, contenidos y capacidades de cómputo, que pueden ser consumidas indistintamente del lugar de donde se encuentren, utilizando un computador o dispositivo inteligente.The goal of the present research was to implement a cloud platform for open massive online courses (MOOC) using Google Course Builder and Virtual Desktop Infrastructures. Through this infrastructure was published an online course about Operating Systems subject. It was applied in Engineering in Systems School of the Faculty of Computer Science and Electronics at Escuela Superior Politécnica de Chimborazo. It was developed a technological solution, using cloud computing models and services, which managed to create one of the important challenges of e-learning solutions, such as computer labs. The solution design is composed of an open-type toolkit, which uses the three cloud services, such as: infrastructure as a service (laaS) to provide virtual desktops (VDI) using Open UDS, platform as a service (PaaS) for publish online courses with Google Course Builder (GCB) and software as a service (SaaS) to provide a set of applications available on the network. This process of development and deployment was guided by the SCRUM methodology, which allowed to meet the requirements established by the user, times and deliverables generated in each iteration. The implementation of these services got a 90% of acceptance. Thus, it obtained similar benefits to those achieved by the physical laboratories of educational institutions. The integrations of cloud services are conducive to the recreation of e-learning scenarios with virtual computer labs that support the practical development of a class. The use of this solution is suggested to educational units, since students have access to an infinite number of applications, contents and computing capabilities, which can be used no matter where people are, using computer or smart device

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio