Estilos de aprendizaje de los estudiantes de medicina veterinaria de la Universidad Nacional de Rosario, Argentina

El objetivo del trabajo fue identificar los estilos de aprendizaje predominantes de los estudiantes de medicina veterinaria y determinar si existen diferencias en las preferencias cognitivas entre los alumnos del ciclo de formación básica y superior de la carrera. Para ello se encuestaron 76 estudiantes de la Universidad Nacional de Rosario (Argentina), aplicando el inventario de estilos de aprendizaje de Felder y Silverman, que valora la preferencia hacia los estilos activo o reflexivo (tipo de procesamiento), sensorial o intuitivo (tipo de percepción), visual o verbal (tipo de representación) y secuencial o global (tipo de comprensión). Las preferencias cognitivas de los estudiantes encuestados de ambos ciclos de formación se orientaron hacia lo activo, sensorial, visual y secuencial. Sin embargo, en el ciclo básico se hallaron diferencias estadísticamente significativas en los estilos de procesamiento y percepción según año de ingreso. Así, los estudiantes con dos o más años de trayectoria en la carrera presentaron mayores grados de preferencia por los estilos activo y sensorial que los ingresantes. Estos resultados apoyan la hipótesis de diferencias cognitivas en el aprendizaje. En este estudio se comprobó que la mayor parte de los estudiantes analizados prefieren aprender mediante los estilos activo, sensorial, visual y secuencial. Además, existe una profundización de estas preferencias a medida que permanecen más años en la carrera. La evaluación de las características psicológicas del alumnado permitiría el diseño de clases adecuadas a sus necesidades educativas facilitando la construcción de conocimientos en la universidad

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Abstract:  Objective: to assess the adjusted Global Antiphospholipid Syndrome Score (aGAPSS) instrument to estimate the risk of vascular thrombosis in primary antiphospholipid syndrome (pAPS). A retrospective study was done between 2013-2020, including patients with pAPS by Sydney criteria. The presence of arterial and venous thrombosis (tAPS), obstetrical comorbidity (oAPS), non-criteria manifestations (NCM), antiphospholipid antibodies (APLA), recurrent thrombosis and mortality were evaluated. Patients were grouped in tAPS, oAPS or both; the last one was used when the stratification was done. In the first visit, aGAPSS was calculated by adding: arterial hypertension: 1, hyperlipidemia: 3, moderate-high titles of anti-cardiolipin antibody (aCL): 5, anti-β2glicoprotein I (aB2GPI): 4 and lupus anticoagulant (LA): 4. aGAPSS ≥ 10 was considered high. Results: 85 patients entered the study, 74,11% completed the follow-up. 87,1% were women, mean age was 36 years (32,75-40,25), illness of 53 months (25-114). 62,35% had oAPS, 24,5% tAPS and 12,94% both. There were 18 arterial thrombosis, 11 venous thrombosis and 3 in both sites. Patients with tAPS had longer illness (p=0,04), higher rates of aB2GP1 (p=<0,001) and triple positivity (p=0,0003). The mean aGAPSS was 9 (5-12); in tAPS the mean value was 9 (8,75-13) and in oAPS 9 (5-9); p=0,008. There was no difference between patients with criteria manifestations and NCM. New trombosis (12,69%) happened in tAPS; the mean time was 26 months (15-49). There were 4 arterial thrombosis, 2 venous thrombosis and 2 in both sites. The mean aGAPSS in patients with recurrence was 13 (9-13), 62,50% had aGAPSS ≥ 10; and 87% had MNC. 4 (6,34%) patients died, all of them with recurrent thrombosis. aGAPSS ≥ 10 predicted new thrombosis (p=0,016). Patients with recurrence had a worse survival curve (p= 0,00000). Conclusion: assessing the risk of thrombosis in APS with aGAPSS could identify individuals at high risk of recurrence, monitor them, and intervene to prevent future events.Resumen:  Objetivo: valorar el instrumento Global Antiphospholipid Sydrome Score ajustado (aGAPSS) para estimar riesgo de trombosis vascular en SAF primario (SAFP). Se realizó un estudio retrospectivo incluyendo pacientes con SAFP (criterios de Sydney) entre 2013 y 2020 de Hospital Materno-neonatal y Córdoba. Se analizaron: trombosis venosa y arterial (SAFT), morbilidad obstétrica (SAFO), manifestaciones no criterio (MNC), anticuerpos antifosfolípidos (AAF), recurrencia de trombosis y mortalidad. Se agruparon en SAFT, SAFO o ambas; el último grupo se utilizó para estratificación del riesgo. En visita basal calculamos aGAPPS sumando: HTA: 1, dislipemia: 3, anticuerpos anticardiolipinas (ACA) IgM/IgG títulos moderados-altos: 5, anticuerpos antibeta2glicoproteína I (ABGPI): 4 y anticoagulante lúpico (AL): 4. Se consideró aGAPSS alto  ≥ 10. Las variables continuas se expresaron como mediana y rango intercuartil; las categóricas como frecuencia y porcentaje. Se utilizó el test de Fisher para variables categóricas y test de Wilcoxon para variables mensurables. p < 0,05 fueron significativos. Aprobado por CIEIS del Adulto. Resultados: Ingresaron 85 pacientes, 74,11% completaron seguimiento. 87,1% mujeres, mediana de edad 36 años (32,75-40,25). 62,35% presentaban SAFO, 24,5% SAFT y 12,94% ambas. Presentaron 18 trombosis arteriales, 11 venosas y 3 en ambos sitios. Pacientes con SAFT tuvieron mayor duración de enfermedad (p=0,04), mayores tasas de ABGP1 (p=<0,001) y triple positividad (p=0,0003). La mediana del aGAPSS fue de 9 (5-12). En SAFT la mediana fue 9 (8,75-13) y en SAFO 9 (5-9); p=0,008. No hubo diferencia entre pacientes con manifestaciones criterio vs MNC. Las nuevas trombosis 12,69% ocurrieron en SAFT; la mediana del tiempo fue 26 meses (15-49). 4 fueron arteriales, 2 venosas y 2 ambas. La mediana de aGAPSS en pacientes con recurrencia fue 13 (9-13), 62,50% con GAPSS ≥ 10; y 87% presentaron MNC. 4 (6,34 %) pacientes fallecieron, todos con retrombosis. aGAPSS ≥ 10 predijo nuevas trombosis (p=0,016). Los pacientes con retrombosis tuvieron peor curva de sobrevida (p= 0,00000). Conclusión: La valoración del riesgo de trombosis en SAF con aGAPSS permitiría identificar individuos con alto riesgo de recurrencia, monitorizarlos e intervenir para prevenir futuros eventos.

Association of intronic variants of the KCNAB1 gene with lateral temporal epilepsy.

The KCNAB1 gene is a candidate susceptibility factor for lateral temporal epilepsy (LTE) because of its functional interaction with LGI1, the gene responsible for the autosomal dominant form of LTE. We investigated association between polymorphic variants across the KCNAB1 gene and LTE. The allele and genotype frequencies of 14 KCNAB1 intronic SNPs were determined in 142 Italian LTE patients and 104 healthy controls and statistically evaluated. Single SNP analysis revealed one SNP (rs992353) located near the 3'end of KCNAB1 slightly associated with LTE after multiple testing correction (odds ratio=2.25; 95% confidence interval 1.26-4.04; P=0.0058). Haplotype analysis revealed two haplotypes with frequencies higher in cases than in controls, and these differences were statistically significant after permutation tests (Psim=0.047 and 0.034). One of these haplotypes was shown to confer a high risk for the syndrome (odds ratio=12.24; 95% confidence interval 1.32-113.05) by logistic regression analysis. These results support KCNAB1 as a susceptibility gene for LTE, in agreement with previous studies showing that this gene may alter susceptibility to focal epilepsy

Lung Retransplantation with Positive Crossmatch in Primary Lung Transplantation Complicated by Antibody-Mediated Rejection

La hipertensión arterial pulmonar (HAP) representa el 2,6% de los trasplantes pulmonares (TP), con una mediana de supervivencia condicional(desde los 30 días del TP) de 9,8 años. Son frecuentes, el rechazo celular agudo (ACR) y la disfunción crónica del injerto (CLAD),mientras que es infrecuente el rechazo mediado por anticuerpos (AMR). El retrasplante pulmonar (RTP) constituye el 4% del TP mundial,debido a complicaciones en la vía aérea, disfunción primaria del injerto, ACR y CLAD. Mujer de 22 años, portadora de HAP idiopática(HAPI) desde el año 2013, trasplantada bipulmonar (TBP) en enero de 2018. A los 16 meses presentó neumonía adquirida en la comunidad.En una internación posterior, presentó ACR y a pesar de pulsos de metilprednisolona, progresó a requerimientos de cánula de altoflujo y ventilación mecánica no invasiva hospitalaria, caída del VEF1, y tomografía de tórax con vidrio esmerilado difuso y engrosamientoirregular reticular del intersticio subpleural; interpretándose como CLAD a predominio de síndrome de bronquiolitis obliterante (BOS),con presencia de anticuerpos específicos contra el donante (DSA). En enero de 2020 se realizó nuevo TP y ante cross-match positivo, serealizó plasmaféresis y reposición de IgG. Al mes del egreso, no se observaron signos de rechazo en control de biopsias transbronquiales.Entre 2 y 10% de los pacientes con indicación primaria de TP por HAPI son sometidos a retrasplante pulmonar (RTP). La presencia deDSA y el miss-match de HLA, no son contraindicaciones para el RTP.Pulmonary arterial hypertension (PAH) represents 2.6% of lung transplantations (LT), with a conditional median survival (from 30 days after LT) of 9.8 years. Acute cellular rejection (ACR) and chronic lung allograft dysfunction (CLAD) are common; whereas the antibody-mediated rejection (AMR) is not. Lung retransplantation (LR) accounts for 4% of global LTs for complications in the airways, primary allograft dysfunction, ACR and CLAD. 22-year-old woman with idiopathic PAH (IPAH) since 2013, who underwent a double-lung transplantation (DLT) in January 2018. 16 months after transplantation she presented community-acquired pneumonia. During a subsequent hospitalization, she presented ACR. Despite the fact that she received pulse methylprednisolone, she required high-flow cannula therapy and hospital non-invasive mechanical ventilation; the FEV1 was reduced and she underwent a chest tomography with diffuse ground glass opacities and irregular reticular thickening of the subpleural interstitium; interpreting the predominance of BOS (bronchiolitis obliterans syndrome) as CLAD, with presence of donor-specific antibodies (DSA). In January 2020, she received a new DLT and due to a positive crossmatch, she was treated with plasmapheresis and IgG replacement. One month after hospital discharge, no signs of rejection were observed at the BTB (bone-patellar tendon-bone) control. Between 2 to 10% of patients with primary indication of LT for IPAH are subjected to lung retransplantation (LR). The presence of DSA and HLA (human leucocyte antigen) mismatch aren’t contraindications to LR.Fil: Calderón Soriano, Juan C.. Fundación Favaloro; ArgentinaFil: Nazzo, María V.,. Fundación Favaloro; ArgentinaFil: Pérez Páez, Martha I.. Fundación Favaloro; ArgentinaFil: Virhuez, Yblin. Fundación Favaloro; ArgentinaFil: Balcazar, Jonathan. Fundación Favaloro; ArgentinaFil: Vicente, Luis. Fundación Favaloro; ArgentinaFil: Ahumada, Rosalía. Fundación Favaloro; ArgentinaFil: Osses, Juan M.. Fundación Favaloro; ArgentinaFil: Vigliano, Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Medicina Traslacional, Trasplante y Bioingeniería. Fundación Favaloro. Instituto de Medicina Traslacional, Trasplante y Bioingeniería; ArgentinaFil: Bertolotti, Alejandro Mario. Fundación Favaloro; ArgentinaFil: Caneva, Jorge O.. Fundación Favaloro; Argentin

Impact of Aetiological Treatment on Conventional and Multiplex Serology in Chronic Chagas Disease

The main criterion for treatment effectiveness in Chagas Disease has been the seronegative conversion of previously reactive serology, generally achieved many years post-treatment. The lack of reliable tests to ensure parasite clearance and to examine the effect of treatment is the main difficulty in evaluating treatment for chronic Chagas disease. Decreases of conventional and non-conventional serological titers can be useful tools to monitor the early impact of treatment. We serially measured changes in antibody levels, including seronegative conversion as well as declines in titers in 53 benznidazole-treated and 89 untreated chronically T. cruzi-infected subjects. Seronegative conversion as well as decreases of titers was significantly higher in treated compared with untreated patients. A strong concordance was found between decreases of titers of conventional and non-conventional serologic tests post-treatment, reaffirming the findings. When seronegative conversion plus decreases of titers were considered altogether, the impact of treatment was higher, in a shorter follow-up period than previously considered. New tools for monitoring the effectiveness of treatment of chronic Chagas disease are necessary, and the results showed in this study is a contribution to researchers and physicians who assist patients suffering from this disease

White Paper and Roadmap for Quantum Gravity Phenomenology in the Multi-Messenger Era

The unification of quantum mechanics and general relativity has long been elusive. Only recently have empirical predictions of various possible theories of quantum gravity been put to test. The dawn of multi-messenger high-energy astrophysics has been tremendously beneficial, as it allows us to study particles with much higher energies and travelling much longer distances than possible in terrestrial experiments, but more progress is needed on several fronts. A thorough appraisal of current strategies and experimental frameworks, regarding quantum gravity phenomenology, is provided here. Our aim is twofold: a description of tentative multimessenger explorations, plus a focus on future detection experiments. As the outlook of the network of researchers that formed through the COST Action CA18108 "Quantum gravity phenomenology in the multi-messenger approach (QG-MM)", in this work we give an overview of the desiderata that future theoretical frameworks, observational facilities, and data-sharing policies should satisfy in order to advance the cause of quantum gravity phenomenology.Comment: Submitted to CQG for the Focus Issue on "Quantum Gravity Phenomenology in the Multi-Messenger Era: Challenges and Perspectives". Please contact us to express interesst of endorsement of this white pape

White Paper and Roadmap for Quantum Gravity Phenomenology in the Multi-Messenger Era

The unification of quantum mechanics and general relativity has long been elusive. Only recently have empirical predictions of various possible theories of quantum gravity been put to test. The dawn of multi-messenger high-energy astrophysics has been tremendously beneficial, as it allows us to study particles with much higher energies and travelling much longer distances than possible in terrestrial experiments, but more progress is needed on several fronts. A thorough appraisal of current strategies and experimental frameworks, regarding quantum gravity phenomenology, is provided here. Our aim is twofold: a description of tentative multimessenger explorations, plus a focus on future detection experiments. As the outlook of the network of researchers that formed through the COST Action CA18108 "Quantum gravity phenomenology in the multi-messenger approach (QG-MM)", in this work we give an overview of the desiderata that future theoretical frameworks, observational facilities, and data-sharing policies should satisfy in order to advance the cause of quantum gravity phenomenology

Inhibitory Receptors Are Expressed by Trypanosoma cruzi-Specific Effector T Cells and in Hearts of Subjects with Chronic Chagas Disease

We had formerly demonstrated that subjects chronically infected with Trypanosoma cruzi show impaired T cell responses closely linked with a process of T cell exhaustion. Recently, the expression of several inhibitory receptors has been associated with T cell dysfunction and exhaustion. In this study, we have examined the expression of the cytotoxic T lymphocyte antigen 4 (CTLA-4) and the leukocyte immunoglobulin like receptor 1 (LIR-1) by peripheral T. cruzi antigen-responsive IFN-gamma (IFN-γ)-producing and total T cells from chronically T. cruzi-infected subjects with different clinical forms of the disease. CTAL-4 expression was also evaluated in heart tissue sections from subjects with severe myocarditis. The majority of IFN-γ-producing CD4+ T cells responsive to a parasite lysate preparation were found to express CTLA-4 but considerably lower frequencies express LIR-1, irrespective of the clinical status of the donor. Conversely, few IFN-γ-producing T cells responsive to tetanus and diphtheria toxoids expressed CTLA-4 and LIR-1. Polyclonal stimulation with anti-CD3 antibodies induced higher frequencies of CD4+CTAL-4+ T cells in patients with severe heart disease than in asymptomatic subjects. Ligation of CTLA-4 and LIR-1 with their agonistic antibodies, in vitro, reduces IFN-γ production. Conversely, CTLA-4 blockade did not improved IFN-γ production in response to T. cruzi antigens. Subjects with chronic T. cruzi infection had increased numbers of CD4+LIR-1+ among total peripheral blood mononuclear cells, relative to uninfected individuals and these numbers decreased after treatment with benznidazole. CTLA-4 was also expressed by CD3+ T lymphocytes infiltrating heart tissues from chronically infected subjects with severe myocarditis. These findings support the conclusion that persistent infection with T. cruzi leads to the upregulation of inhibitory receptors which could alter parasite specific T cell responses in the chronic phase of Chagas disease

A detailed study of the very-high-energy Crab pulsar emission with the LST-1

Context: There are currently three pulsars firmly detected by imaging atmospheric Cherenkov telescopes (IACTs), two of them reaching TeV energies, challenging models of very-high-energy (VHE) emission in pulsars. More precise observations are needed to better characterize pulsar emission at these energies. The LST-1 is the prototype of the Large-Sized Telescope, that will be part of the Cherenkov Telescope Array Observatory (CTAO). Its improved performance over previous IACTs makes it well suited for studying pulsars. Aims: To study the Crab pulsar emission with the LST-1, improving and complementing the results from other telescopes. These observations can also be used to characterize the potential of the LST-1 to study other pulsars and detect new ones. Methods: We analyzed a total of $\sim$103 hours of gamma-ray observations of the Crab pulsar conducted with the LST-1 in the period from September 2020 to January 2023. The observations were carried out at zenith angles less than 50 degrees. A new analysis of the Fermi-LAT data was also performed, including $\sim$14 years of observations. Results: The Crab pulsar phaseogram, long-term light-curve, and phase-resolved spectra are reconstructed with the LST-1 from 20 GeV to 450 GeV for P1 and up to 700 GeV for P2. The pulsed emission is detected with a significance of 15.2$σ$. The two characteristic emission peaks of the Crab pulsar are clearly detected (>10$σ$), as well as the so-called bridge emission (5.7$σ$). We find that both peaks are well described by power laws, with spectral indices of $\sim$3.44 and $\sim$3.03 respectively. The joint analysis of Fermi-LAT and LST-1 data shows a good agreement between both instruments in the overlapping energy range. The detailed results obtained in the first observations of the Crab pulsar with LST-1 show the potential that CTAO will have to study this type of sources