Acciones de diseño y desarrollo de objetos educativos digitales: programas institucionales

Dentro del conjunto de acciones contempladas en el programa "Internet en el Aula" para potenciar la implantación eficaz de las TIC en Educación, se halla toda una línea de trabajo cuya finalidad es poner a disposición de la comunidad educativa un catálogo amplio de objetos educativos digitales, disponibles a través de una red federada de repositorios que estarán accesibles a través de los portales educativos de las Comunidades Autónomas y el Ministerio de Educación y Ciencia. Este artículo aborda el análisis de las estrategias seguidas, enfocadas a la reusabilidad, la portabilidad, la interoperabilidad, y el software educativo abierto; el comentario de las acciones en marcha, y el detalle de los planes de desarrollo, publicación y explotación de dichos contenidos

Quality and Composition of Red Wine Fermented with Schizosaccharomyces pombe as Sole Fermentative Yeast, and in Mixed and Sequential Fermentations with Saccharomyces cerevisiae

U radu je ispitana fiziologija kvasca Schizosaccharomyces pombe (soj 938) upotrijebljenog za proizvodnju crnog vina. Provedeno je više tipova fermentacija: s kvascem Schizosaccharomyces pombe 938, s mješovitom kulturom kvasaca Sc. pombe i Saccharomyces cerevisiae 796, te fermentacija prvo s pomoću Sc. pombe, a zatim s pomoću S. cerevisiae. Za dodatnu su usporedbu provedene fermentacije samo s kvascem S. cerevisiae, za što je upotrijebljen komercijalni pripravak bakterija mliječne kiseline, koje su provele malolaktičnu fermentaciju po završetku alkoholne fermentacije. Za razliku od kvasca S. cerevisiae, kvasac Sc. pombe provodi maloalkoholnu fermentaciju, pri čemu se smanjuje koncentracija jabučne kiseline u vinu. Tijekom fermentacije praćeni su sljedeći parametri: relativna gustoća; koncentracija octene, jabučne i piruvatne kiseline; početne koncentracije amino dušika i uree; te pH-vrijednost mošteva. U svim fermentacijama u kojima je sudjelovao kvasac Sc. pombe 938 jabučna je kiselina (početne koncentracije od 5,5 g/L) gotovo potpuno upotrijebljena za rast kvasaca, a nastala je umjerena koncentracija octene kiseline (manja od 0,4 g/L). Udjel je uree u tim vinima bio deset puta manji nego u vinima fermentiranim samo s kvascem S. cerevisiae 796. Senzorska su se svojstva vina dobivenih različitim tipovima fermentacija bitno razlikovala. Vina fermentirana s pomoću kvasca Sc. pombe 938 imala su najbolju kakvoću i intenzitet arome, pa su dobila najbolje ocjene pri senzorskoj analizi uzoraka vina.This work examines the physiology of Schizosaccharomyces pombe (represented by strain 938) in the production of red wine, as the sole fermentative yeast, and in mixed and sequential fermentations with Saccharomyces cerevisiae 796. For further comparison, fermentations in which Saccharomyces cerevisiae was the sole fermentative yeast were also performed; in these fermentations a commercial lactic acid bacterium was used to perform malolactic fermentation once alcoholic fermentation was complete (unlike S. cerevisiae, the Sc. pombe performs maloalcoholic fermentation and therefore removes malic acid without such help). Relative density, acetic, malic and pyruvic acid concentrations, primary amino nitrogen and urea concentrations, and pH of the musts were measured over the entire fermentation period. In all fermentations in which Sc. pombe 938 was involved, nearly all the malic acid was consumed from an initial concentration of 5.5 g/L, and moderate acetic acid concentrations below 0.4 g/L were formed. The urea content of these wines was notably lower, showing a tenfold reduction when compared with those that were made with S. cerevisiae 796 alone. The sensorial properties of the different final wines varied widely. The wines fermented with Sc. pombe 938 had maximum aroma intensity and quality, and they were preferred by the tasters

Normal limits of home measured spatial gait parameters of the elderly population and their association with health variables

Gait studies in the elderly population have been always conducted in gait labs or spacious clinical facilities, which influence gait parameters, and also implies that the participants have to be able to move to these facilities. Indoors gait characteristics of the elderly population have been very little studied. In this study, we aim to define the normal limits of the spatial gait parameters of the elderly, when walking at home, and to analyze relationship existing between the spatial gait parameters to other health variables. For such purpose, we conducted a transversal study on a probabilistic sample of 431 Spanish community-dwelling older, in which the spatial gait parameters were recorded by using an ink footprints method. We found that the mean stride length indoors was 88.47 cm (SD:26.05 cm; mean CI95%:85.52-91.41 cm), and the mean step width was 10.34 cm (SD:4.37 cm; mean CI95%:9.84-10.83 cm). Stride length was shorter in women and the oldest group, and was significantly influenced by the strength, balance, and physical activity. Stride width was larger in the oldest group and mainly affected by balance. A composite parameter including width and normalized stride length was independent from sex, and strongly differentiated between age groups. This parameter was affected by strength

Factores de Riesgo Asociados a la Conducta Homicida de un Niño hacia un Par

Los casos de niños homicidas son escasos, pero tienen gran impacto social y legislativo, llevando al estudio de factores de riesgo y protectores de la actividad delictiva temprana. Dado el único registro en Chile de un homicidio por parte de un niño, el objetivo de este estudio fue analizar los factores de riesgo individuales y contextuales asociados a dicha conducta homicida de un niño menor de 10 años hacia un par. Se utilizó un diseño de caso único con diagnóstico multidisciplinar, con evaluaciones clínica individual y familiar, neuropsicológica y psiquiátrica. Los principales hallazgos son escasa flexibilidad cognitiva del niño y retroalimentación emocional en sus relaciones familiares, que se asociarían a los factores de riesgo: pautas educativas familiares, características de personalidad y uso del tiempo (jugar videojuegos violentos) y podrían explicar la conducta homicida, donde al niño le sería difícil detener la conducta violenta una vez iniciada, en un contexto demandante emocionalmente

Acciones de diseño y desarrollo de objetos educativos digitales: programas institucionales

Dentro del conjunto de acciones contempladas en el programa "Internet en el Aula" para potenciar la implantación eficaz de las TIC en Educación, se halla toda una línea de trabajo cuya finalidad es poner a disposición de la comunidad educativa un catálogo amplio de objetos educativos digitales, disponibles a través de una red federada de repositorios que estarán accesibles a través de los portales educativos de las Comunidades Autónomas y el Ministerio de Educación y Ciencia. Este artículo aborda el análisis de las estrategias seguidas, enfocadas a la reusabilidad, la portabilidad, la interoperabilidad, y el software educativo abierto; el comentario de las acciones en marcha, y el detalle de los planes de desarrollo, publicación y explotación de dichos contenidos

The Spatial parameters of gait and their association with falls, functional decline and death in older adults: a prospective study

Association between spatial gait parameters and adverse health outcomes in the elderly has not been sufficiently studied. The goal of this study is to evaluate whether the stride length or the step width predict falls, functional loss and mortality. We conducted a prospective cohort study on a probabilistic sample of 431 noninstitutionalized, older-than-64-years subjects living in Spain, who were followed-up for five years. In the baseline visit, spatial gait parameters were recorded along with several control variables, with special emphasis on known medical conditions, strength, balance and functional and cognitive capacities. In the follow-up calls, vital status, functional status and number of falls from last control were recorded. We found that a normalized-to-height stride length shorter than 0.52 predicted recurrent falls in the next 6 months with 93% sensitivity and 53% specificity (AUC: 0.72), and in the next 12 months with 81% sensitivity and 57% specificity (AUC: 0.67). A normalized stride length <0.5 predicted functional loss at 12 months with a sensitivity of 79.4% and specificity of 65.6% (AUC: 0.75). This predictive capacity remained independent after correcting for the rest of risk factors studied. Step-with was not clearly related to functional loss or falls. Both shorter normalized stride length (OR1.56; AUC: 0.62; p < 0.05) and larger step width (OR1.42; AUC: 0.62; p < 0.05) were associated with risk of death at 60 months; however, none of them remained as independent predictor of death, after correcting for other risk factors. In summary, spatial gait parameters may be risk markers for adverse outcomes in the elderly. Step length is independently associated with functional loss and falls at one year, after correction for numerous known risk factors

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

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

Acciones de diseño y desarrollo de objetos educativos digitales: programas institucionales

Dentro del conjunto de acciones contempladas en el programa "Internet en el Aula" para potenciar la implantación eficaz de las TIC en Educación, se halla toda una línea de trabajo cuya finalidad es poner a disposición de la comunidad educativa un catálogo amplio de objetos educativos digitales, disponibles a través de una red federada de repositorios que estarán accesibles a través de los portales educativos de las Comunidades Autónomas y el Ministerio de Educación y Ciencia. Este artículo aborda el análisis de las estrategias seguidas, enfocadas a la reusabilidad, la portabilidad, la interoperabilidad, y el software educativo abierto; el comentario de las acciones en marcha, y el detalle de los planes de desarrollo, publicación y explotación de dichos contenidos