Secuencia paleomagnética y paleolítica del Cuaternario aluvial del Bajo Guadalquivir: actualización y nuevos resultados

One proceeds to check the chronology attributed to the General Sequence of the Guadalquivir (SGG) by means of the application of the palaeomagnetic to his terraces. This one remains concentrated on more than 1.5 M.a with presence of lithic artifact of Achaelian adscription from ends of the Lower Pleistocene (0.9 M.a) until ends of the Middle Pleistocene

Association of Candidate Gene Polymorphisms With Chronic Kidney Disease: Results of a Case-Control Analysis in the Nefrona Cohort

Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to better predict the risk of CKD in the population. Here, we analyzed the genetic association of 79 SNPs of proteins associated with mineral metabolism disturbances with CKD in a cohort that includes 2, 445 CKD cases and 559 controls. Genotyping was performed with matrix assisted laser desorption ionizationtime of flight mass spectrometry. We used logistic regression models considering different genetic inheritance models to assess the association of the SNPs with the prevalence of CKD, adjusting for known risk factors. Eight SNPs (rs1126616, rs35068180, rs2238135, rs1800247, rs385564, rs4236, rs2248359, and rs1564858) were associated with CKD even after adjusting by sex, age and race. A model containing five of these SNPs (rs1126616, rs35068180, rs1800247, rs4236, and rs2248359), diabetes and hypertension showed better performance than models considering only clinical risk factors, significantly increasing the area under the curve of the model without polymorphisms. Furthermore, one of the SNPs (the rs2248359) showed an interaction with hypertension, being the risk genotype affecting only hypertensive patients. We conclude that 5 SNPs related to proteins implicated in mineral metabolism disturbances (Osteopontin, osteocalcin, matrix gla protein, matrix metalloprotease 3 and 24 hydroxylase) are associated to an increased risk of suffering CKD

Autoeficacia percibida en pacientes tras programa de rehabilitación cardíaca en atención primaria: Un nuevo modelo de atención

Background: The literature points to the possibility of carrying out an intervention, from primary prevention to rehabilitation after a cardiac event, towards decreasing the incidence of such cardiac events and facilitating the return to daily life. The objective was to determine the effect of a cardiac rehabilitation intervention over perceived selfefficacy for patients who have suffered a cardiac event. Methods: A community clinical trial, open, controlled, and randomised, was designed, and performed in primary care. To determine the sample size, the research team used the General Self-Efficacy Scale by Baessler and Schwarzer. The mean difference between groups considered of clinical relevance was of at least 6 points in the aforementioned General Self-Efficacy Scale. A precision of 95% and a test power of 80% were accepted. The result proposed a sample of 44 subjects in each group. Over 12 months, all subjects of legal age (N=104), both sexes, that had concluded phase II in the cardiac rehabilitation unit of the University Hospital Puerta del Mar (Cadiz) were offered to participate in the study. The patients were informed about the study development, asking for their participation and providing them with a written informed consent. The subjects were randomly assigned to the intervention or control group through blind allocation (in a sealed envelope to the researcher), on a preset 2:1 ratio (two patients assigned to the intervention group to one assigned to the control group). A non-response or rejection to participate in the study record was made for the non-response analysis. Results: A total of 89 subjects were included in the statistical analysis (response rate of 85.57%), with an average age of 63.01 years (SD: 8.75). The main dependent variable was the scores difference between groups, comparing means before and after the intervention, through the General Self-Efficacy Scale by Baessler & Schwarner. A mean difference of 6.0972 points was obtained between the intervention and the control groups (p<0.0053; 95% CI -4.1950 to -10.29), as a result of a 3.3750 mean points increase (standard deviation: 7.01) in the intervention group and a 3.3750 mean points decrease (standard deviation: 7.19) in the control group. In relation to the possible changes to be detected through the Hamilton anxiety scale and the Beck’s depression inventory, after finishing the intervention, an estimate and contrast of population means was made between groups for the scores difference in the Hamilton scale, determined on the final visit, with no significant differences found (t-student 0.1211; p<0.9 43). Similarly, no significant differences were found between the groups for the means obtained in the variable “Beck’s depression inventory scores difference” (t-student -0.1281; p<0.8987). Conclusions: The inclusion in cardiac rehabilitation programmes carried out in primary care improves the general perceived self-efficacy of patients who have suffered cardiac events.Fundamentos: La literatura evidencia la posibilidad de intervención, desde la prevención primaria hasta la rehabilitación tras un evento cardiaco, y así disminuir su incidencia y facilitar la reincorporación a la vida cotidiana. El objetivo de este trabajo fue determinar el efecto sobre la autoeficacia percibida de una intervención en rehabilitación cardiaca a pacientes que han sufrido evento cardíaco. Métodos: Se diseñó un ensayo comunitario abierto, controlado y aleatorizado, realizado en atención primaria de salud. Para determinar el tamaño de muestra, el equipo de investigación utilizó la Escala General de Autoeficacia de Baessler y Schwarzer. La diferencia de medias entre grupos considerada como clínicamente relevante fue de al menos 6 puntos en la puntuación de la Escala General de Autoeficacia. Se aceptó una precisión del 95% y un poder del test del 80%. El resultado propuso una muestra de 44 sujetos en cada grupo. Se propuso participar, a lo largo de 12 meses, a todos los sujetos, mayores de edad (N=104), de ambos sexos, que concluyeron la fase II en la unidad de RHC del Hospital Universitario Puerta del Mar (Cádiz). Se informó a los pacientes de la realización del estudio pidiéndoles su participación y ofreciendo consentimiento informado por escrito. De forma aleatoria, los sujetos fueron asignados aleatoriamente, siendo esta asignación de forma ciega (en sobre cerrado al investigador), al grupo de intervención o de control, mediante una proporción preestablecida 2:1 (dos pacientes a asignados a grupo intervención por uno a grupo control. Se realizó un registro de la no respuesta o rechazo a participar en el estudio para el análisis de la no respuesta. Resultados: Un total de 89 sujetos fueron incluidos en el análisis estadístico (tasa de respuesta de 85,57%), con una edad media de 63,01 años, (DE: 8,75). La variable dependiente principal fue la diferencia de puntuación entre grupos, comparando medias, antes y después de la intervención, en la escala general de autoeficacia de Baessler & Schwarner. Se obtuvo diferencia de medias de 6,0972 puntos entre los grupos de intervención y de control (p<0.0053, IC 95% -4,1950 a -10,29), resultado de un aumento de 3,3750 puntos de media en el grupo de intervención (desviación estándar 7,01), y un descenso de 2,7222 puntos de media (desviación estándar 7,19), en el grupo de control. En relación a los posibles cambios a detectar en las escalas de ansiedad de Hamilton e inventario de depresión de Beck, tras finalizar la intervención, se realizó una estimación y contraste de medias poblacionales entre grupos para la diferencia de puntuaciones en la escala de Hamilton, determinadas en la visita final, no encontrándose diferencias significativas (t student 0,1211; p<0,9 43). De igual forma, no se encontraron diferencias significativas entre grupos para las medias obtenidas en la variable “diferencia de puntuación en inventario de Beck en depresión” (t student -0,1281; p < 0,8987). Conclusiones: La inclusión en los programas de rehabilitación cardiaca realizados en atención primaria mejora la autoeficacia general percibida de pacientes que han sufrido eventos cardíacos

Preparation of virtual teaching material for the practices of the Microbiology subject of the Podiatry Degree

El aprendizaje mixto con la incorporación de nuevas tecnologías como vídeos cortos y cuestionarios online ha permitido mejorar el rendimiento, la satisfacción y el compromiso de los estudiantes. El objetivo de este Proyecto de Innovación Docente fue elaborar material docente virtual para las prácticas de la asignatura de Microbiología del Grado de Podología. Al inicio del curso se elaboró un cuestionario para valorar los conocimientos previos en materia de microbiología del alumnado. Posteriormente los alumnos se inscribieron de forma voluntaria a las prácticas de Microbiología eligiendo entre el formato virtual o presencial. El guion teórico de prácticas presenciales se adaptó a un formato virtual incorporando multitud de imágenes y ejemplos prácticos de las pruebas de diagnóstico microbiológico y centrados en dos áreas prioritarias de diagnóstico, las infecciones de pie diabético y las infecciones fúngicas en podología. Posteriormente, realizaron dos casos clínicos prácticos tanto en las prácticas presenciales como en las virtuales. Estos últimos debieron contestar un cuestionario sobre los casos prácticos así como valorar la actividad. Por último, los alumnos respondieron de nuevo al cuestionario de conocimientos planteado al inicio del curso académico. Todo el material fue subido al Campus Virtual para su consulta y resolución. De los 71 alumnos matriculados, 19 (26,8%) eligieron realizar las prácticas en formato virtual y 52 (73,2%) en formato presencial. Tanto las prácticas en formato virtual como presencial mejoraron el rendimiento de los alumnos, observándose un incremento significativo de 1,9 y de 2,0 en la calificación para el grupo de prácticas en formato virtual y presencial, respectivamente. No se observaron diferencias significativas entre ambos formatos (virtual y presencial) en la calificación obtenida después de realizar las prácticas. Se observó un nivel alto de participación de la actividad. Un 71,8% de los alumnos realizaron el cuestionario previo de conocimientos y un 66,2% realizaron el cuestionario de conocimientos después de las prácticas. La participación del alumno que eligió el formato presencial fue superior a la del alumno que eligió el formato presencial. El grado de satisfacción de las prácticas en formato virtual fue elevado ya que se obtuvo un valor medio de 4 sobre 5.Blended learning with the incorporation of new technologies such as short videos and online questionnaires has improved student performance, satisfaction and engagement. The objective of this Teaching Innovation Project was to elaborate virtual teaching material for the practices of the Microbiology of the Podiatry Degree. At the beginning of the course, a questionnaire was developed to assess the students' prior knowledge of microbiology. Subsequently, the students voluntarily enrolled in the Microbiology practices, choosing between the virtual or face-to-face format. The theoretical script of face-to-face practices was adapted to a virtual format incorporating a multitude of images and practical examples of microbiological diagnostic tests and focused on two priority areas of diagnosis, diabetic foot infections and fungal infections in podiatry. Subsequently, they carried out two practical clinical cases in both face-to-face and virtual practices. The latter had to answer a questionnaire on the practical cases as well as assess the activity. Finally, the students responded again to the knowledge questionnaire posed at the beginning of the academic year. All the material was uploaded to the Virtual Campus for consultation and resolution. Of the 71 students enrolled, 19 (26.8%) chose to carry out the practices in virtual format and 52 (73.2%) in face-to-face format. Both the virtual and face-to-face practices improved student performance, observing a significant increase of 1.9 and 2.0 in the grade for the group of virtual and face-to-face practices, respectively. No significant differences were observed between both formats (virtual and face-to-face) in the qualification obtained after carrying out the practices. A high level of participation in the activity was observed. 71.8% of the students took the prior knowledge questionnaire and 66.2% took the knowledge questionnaire after the practices. The participation of the student who chose the face-to-face format was higher than that of the student who chose the face-to-face format. The degree of satisfaction of the practices in virtual format was high since an average value of 4 out of 5 was obtained.Depto. de MedicinaFac. de MedicinaFALSEsubmitte

Effectiveness of anakinra for tocilizumab-refractory severe COVID-19: A single-centre retrospective comparative study.

A subgroup of patients with SARS-CoV-2 infection was thought to have developed cytokine release syndrome and were treated with tocilizumab; however, a significant percentage of patients evolved. This study aimed to determine the usefulness of anakinra as a rescue treatment for patients with tocilizumab-refractory COVID-19 disease. A prospective cohort of patients with COVID-19 pneumonia who received anakinra as salvage therapy after failure of tocilizumab were compared (1:1) with selected controls in a historical cohort of patients treated with tocilizumab. Cases and controls were matched by age, comorbidities, pulse oximetry oxygen saturation to fraction of inspired oxygen (SpO2/FiO2) ratio at baseline, and time elapsed since the initiation of treatment with tocilizumab. The primary outcome was the improvement in clinical status measured by a 6-point ordinal scale, from baseline to day 21. The study included 20 cases and 20 controls (mean age 65.3 ± 12.8 years, 65% males). No differences were found in the clinical improvement rates at 7, 14 and 21 days of follow-up. The in-hospital mortality rate for patients receiving anakinra was 55% vs. 45% in the control group (P = 0.527). Treatment with anakinra was not useful in improving the prognosis of patients with tocilizumab-refractory severe COVID-19.This work was supported by Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation (COV20/00181) — co‐financed by European Development Regional Fund “A way to achieve Europe”. M.F.R. holds a research contract “Miguel Servet” (CP18/00073) from the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III.S

mTORC1-dependent AMD1 regulation sustains polyamine metabolism in prostate cancer

Activation of the PTEN-PI3K-mTORC1 pathway consolidates metabolic programs that sustain cancer cell growth and proliferation. Here we show that mechanistic target of rapamycin complex 1 (mTORC1) regulates polyamine dynamics, a metabolic route that is essential for oncogenicity. By using integrative metabolomics in a mouse model and human biopsies of prostate cancer, we identify alterations in tumours affecting the production of decarboxylated S-adenosylmethionine (dcSAM) and polyamine synthesis. Mechanistically, this metabolic rewiring stems from mTORC1-dependent regulation of S-adenosylmethionine decarboxylase 1 (AMD1) stability. This novel molecular regulation is validated in mouse and human cancer specimens. AMD1 is upregulated in human prostate cancer with activated mTORC1. Conversely, samples from a clinical trial with the mTORC1 inhibitor everolimus exhibit a predominant decrease in AMD1 immunoreactivity that is associated with a decrease in proliferation, in line with the requirement of dcSAM production for oncogenicity. These findings provide fundamental information about the complex regulatory landscape controlled by mTORC1 to integrate and translate growth signals into an oncogenic metabolic program