Impact indicators of educational innovations based on active methodologies

"Think global, act locally" is one of the phrases that define the idea of any innovation. It denotes that the impact must be global and contribute to the advancement of knowledge in a specific sector, for example. The innovation applied in the classroom is known as “teaching educational innovation” and thinking in global is complicated because innovation is carried out in a specific subject. Specific contexts have needs and conditions that difficult the transference outside the subject itself. This work provides a method to consider any teaching educational innovation in global terms, even before knowing the specific innovation method to apply. In this way, transferability would be enhanced and the global impact on the change of the educational model would be improved. For this purpose, a study has been carried out with more than 85 professors from different universities. The objective of the study is to show that they have a common vision on the indicators to measure the leaning impact when they apply teaching educational innovation in their own subjects

Cutaneous Leukemic Infiltration Following Varicella - a Case of Wolf's Isotopic Response

Wolf's isotopic response designates the appearance of two subsequent unrelated dermatoses in the same anatomic location. We report the case of a 51-year-old man with a medical history of chronic lymphocytic leukemia without known extra-hematopoietic involvement. The patient developed a disseminated papulo-vesiculous eruption, diagnosed as varicella. Few days after recovering, an erythematous and violaceous papular dermatosis with histopathological examination compatible with leukemic infiltration appeared on the scars of previous herpetic lesions. Complete remission was obtained under systemic corticotherapy, without cutaneous recurrence or blastic transformation. Wolf's isotopic response is attributed to a localized immunologic imbalance following a certain stimulus. In this patient, herpetic infection acted as a local spur for inaugural cutaneous leukemic infiltration, with no impact on the prognosis for the underlying disease.info:eu-repo/semantics/publishedVersio

Development and validation of a new glaucoma screening test using temporally modulated flicker

Purpose Describing the psychometric characteristics and diagnostic accuracy of the Accelerator 4‐Alternative Forced‐Choice Flicker Test prototype (A4FTp) for detecting chronic open angle glaucoma (COAG). Methods A4FTp measures temporally‐modulated flicker thresholds in regions of the visual field with high susceptibility to glaucomatous loss. We initially evaluated its psychometric properties on 20 normals (aged 33.8 ± 8.5 years) who were tested multiple times over a period of 3 months. All subjects underwent four repetitions for shorter (T8) and longer (T12) staircase termination criteria, to determine the most suitable threshold criterion. Four randomly selected subjects underwent a total of 10 repetitions to study test‐retest repeatability and learning effects. To determine its diagnostic accuracy, one eye of 40 participants with COAG and 38 normal controls were tested with the A4FTp in comparison with the Frequency Doubling Technology (FDT; C20‐5 programme) and iVue Spectral Domain Optical Coherence Tomography (SD‐OCT). Tests were conducted in a random order with results masked to the clinician conducting the reference ophthalmic examination. The accuracy of each test was determined by analysis of the area under the receiver operator characteristic curve (AUROC). Results A4FTp flicker thresholds were stable, with standard deviations of only 0.52 decilog (dL) for T8, increasing to 1.32 dL for T12, and no significant flicker sensitivity threshold improvement over the 10 repeat runs. T8 was superior to T12 on several other measures, so it was used for the remaining comparisons. In terms of diagnostic accuracy, the mean AUROC for the three tests were A4FTp [T8 criterion; 0.82, 95% confidence interval (0.73–0.92)]; SD‐OCT [any RNFL parameter p < 1% level; 0.90 (0.83–0.97)]; and FDT [one or more locations missed at p < 5% level; 0.91 (0.82–0.96)]. There was no statistical difference in AUROC between A4FTp and SD‐OCT (p = 0.18) or FDT (p = 0.12). The A4FTp test duration averaged just over 2 min per eye, taking approximately one‐third of the time for completion of the HFA SITA 24‐2 algorithm (conducted as part of the reference examination) and twice the time for the suprathreshold FDT. Conclusion Test accuracy for the A4FTp was comparable to those of the FDT and SD‐OCT for the detection of COAG. Time taken to complete the A4FTp was relatively short and initial results are promising. With further refinement, the A4FTp could have a future role in glaucoma detection

Un modelo de programación linear entera para planificación de corta y de aclareo en masas de Pinus pinaster

The study addresses the special case of a management plan for maritime pine (Pinus pinaster Ait.) in common lands. The study area refers to 4,432 ha of maritime pine stands in North Portugal (Perímetro Florestal do Barroso in the county of Ribeira de Pena), distributed among five common lands called baldio areas. Those lands are co-managed by the Official Forest Services and the local communities, essentially for timber production, using empirical guidance. As the current procedure does not guarantee the best thinning and clear-cutting scheduling, it was considered important to develop “easy-to-use” models, supported by optimization techniques, to be employed by the forest managers in the harvest planning of these communitarian forests. Planning of the thinning and clear-cutting operations involved certain conditions, such as: (1) the optimal age for harvesting; (2) the maximum stand density permitted; (3) the minimum volume to be cut; (4) the guarantee of incomes for each of the five baldios in at least a two year period; (5) balanced incomes during the length of the projection period. In order to evaluate the sustainability of the wood resources, a set of constraints lower bounding the average ending age was additionally tested. The problem was formulated as an integer linear programming model where the incomes from thinning and clear-cutting are maximized while considering the constraints mentioned above. Five major scenarios were simulated. The simplest one allows for silvicultural constraints only, whereas the other four consider these constraints besides different management options. Two of them introduce joint management of all common areas with or without constraints addressing balanced distribution of incomes during the plan horizon, whilst the other two consider the same options but for individual management of the baldios. The proposed model is easy to apply, providing immediate advantages for short and mid-term planning periods compared to the empirical methods of harvest planning. Results showed that maximization of production is reached when there are silvicultural restrictions only and when forest management units are regarded as a joint undertaking. The individualized management with a balanced distribution of incomes is an interesting option as it does not drastically reduce the optimal solution while assuring benefits at least every two years.Este estudio trata de desarrollar un plan de gestión para una masa continua de pino marítimo en el Norte de Portugal (Perímetro Florestal do Barroso, en el municipio de Ribeira de Pena). El área de estudio ocupa 4.432 ha y se localiza en cinco zonas comunales denominadas áreas de baldío. Las zonas de baldíos las gestionan los Servicios Oficiales forestales y las comunidades locales, principalmente con el objetivo de producción de madera. La venta del material garantiza un importante rendimiento a las populaciones. Actualmente la gestión se hace de forma empírica, pero se ha considerado importante desarrollar un modelo, basado en técnicas de optimización, que pudiese ser utilizado fácilmente por los gestores. La planificación de las operaciones de corta y de aclareo de estas zonas debe tener en cuenta ciertas condiciones, como por ejemplo: (1) la edad óptima para la corta, (2) la densidad máxima de la masa, (3) el volumen mínimo a cortar, (4) la garantía de ingresos/rendimiento para cada uno de los cinco baldíos, al menos para un periodo de tiempo de dos años, (5) un equilibrio de ingresos/rendimiento durante la duración del plan de gestión. Con el fin de evaluar la sostenibilidad de los recursos madereros de las soluciones óptimas, se ha probado un conjunto de restricciones que limitan la edad final. La programación lineal entera se utilizó para abordar el problema, buscando maximizar los ingresos relacionados con el clareo y corta, teniendo en cuenta las limitaciones mencionadas anteriormente. Se simularon cinco escenarios principales. El más simple tuvo en cuenta solamente limitaciones silvícolas, mientras que los otros dos tienen en cuenta estas limitaciones, además de considerar diferentes opciones de manejo. En dos de ellos se considera la gestión conjunta de todas las zonas, con las opciones de garantizar, o no, una distribución regular de recetas, mientras que en los otros dos se considera la gestión individual de los baldíos, con las opciones ya referidas. Los resultados mostraron que se alcanza la maximización de la producción cuando hay sólo restricciones silvícolas y cuando las unidades de manejo forestal se consideran en conjunto

Patch Tests Under Systemic Immunossupression - An Absolute Contra-Indication?

Introdução: As provas epicutâneas (PE) são o exame complementar de diagnóstico indicado para avaliação de suspeita de dermite de contacto alérgica. Idealmente, devem ser realizadas sem que o doente se encontre sob imunossupressores. Existem contudo situações clínicas em que tal não é possível, não havendo informação disponível acerca de como realizar e valorizar os resultados das PE nestes doentes. O objectivo do presente trabalho é rever a literatura no que concerne à realização de PE sob imunossupressão iatrogénica. Material e Métodos: Revisão da literatura relevante para o tema publicada até Janeiro de 2015 e indexada à Medline. Resultados: De acordo com o reportado na literatura, foram realizadas PE em 77 doentes sob corticóide sistémico, 78 doentes sob ciclosporina (CyA), 6 sob azatioprina, 10 sob metotrexato (MTX), 4 sob micofenolato de mofetil (MMF), 11 sob fármacos anti-factor de necrose tumoral e 7 sob fármaco anti-IL-12/23. Foram ainda descritos 15 casos de realização de PE sob associação de imunossupressores. Verificaram-se reacções positivas em todos os grupos. Conclusão: O tratamento concomitante com imunossupressores não deve ser uma contra-indicação para realização de PE, estando descritas reacções positivas em doentes sob prednisolona, azatioprina, CyA, MTX, MMF, infliximab, etanercept, adalimumab e ustecinumab. Os resultados negativos ou duvidosos devem, contudo, ser interpretados de forma cautelosa

Sweet's Syndrome and Relapsing Polychondritis Signal Myelodysplastic Syndrome

Certas dermatoses, pertencentes ao grupo das síndromes paraneoplásicas mucocutâneas, podem ser o prenúncio de uma neoplasia previamente não conhecida. Tanto a síndrome de Sweet como a policondrite recidivante incluem-se neste grupo. A síndrome de Sweet e a PR são raramente encontradas em um mesmo paciente. A presença de policondrite recidivante e síndrome de Sweet em um mesmo paciente tem se revelado mais frequente em pacientes com neoplasias associadas, sobretudo hematológicas. Relata-se o caso de paciente do sexo masculino, 79 anos, com síndrome de Sweet e policondrite recidivante, em quem, subsequentemente, foi diagnosticada uma síndrome mielodisplásica. Palavras-chave: Policondrite recidivante; Síndrome de Sweet; Síndromes paraneoplásica

Leiomiomatose Cutânea em Mãe e Filha

A 34-year-old woman with no known medical history was evaluated for multiple painful brown nodules and papules on the anterior aspect of the trunk. She mentioned a history of similar cutaneous findings on her mother. Biopsies of three lesions revealed piloleiomyomata. Renal and adrenal ultrasound revealed an isolated simple cortical cyst, and pelvic and endovaginal ultrasound revealed two uterine myomata. The clinical diagnosis of hereditary leiomyomatosis and renal cell cancer was corroborated by the identification of a heterozygous variant on exon 5 of the fumarate hydratase gene (c.578C>T p.T193I). Identification of the tumor piloleiomyoma should alert the dermatologist to this rare genodermatosis, which is associated with an increased risk of renal cell tumors, demanding multidisciplinary follow-up, and personal and family counseling