Implementation of learning by doing methods in the graphical engineering field

Regarding the different options to approaches with excessively theoretical contents that are applied in teaching, there are several innovative learning strategies for active students’ involvement. According to (1) most of the business look for professional profiles in which applicants not only have an academic background but also good personal skills, such as initiative, undertaking, communication skills, commercial vision, and so on. This paper presents the experiments that aim to achieve the objectives and catching skills by the Learning by doing technique (2), through a contextualization of the subject “Container and Packaging” in the Industrial Design Degree. Moreover, a close relation between university and business is achieved. In this way students acquire the requirements demanded by the company. A particularization of an industrial design methodology proposed by the Technological Institute of Packaging, Transport and Logistics (ITENE, Valencia) has been implemented for the design of packaging and packaging (4). Besides using this method, students take on a project-based learning (PBL) work under the role of company. Then, they realize the redesign of the container of a manufactured product close to his residence province, i.e. Ron Montero Winery, Granada. This practice will not only look for improving the student's ability to research and solve problems, but also to manage the professional and personal relationships that occur within each work group. These situations are necessary in the training process since they will be to be fought daily in their future professional life.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Promoting Circular Economy around Plastic Waste: A New Design of Recycled Plastic Shredder

The development and construction of the plastic shredder presented here is part of the MAREA Plastic project, which aims to be a meeting point between the university community and society, through science and technology. The project’s main goal consists in developing a circular economy environment that reduces both, the input of raw materials and the output of waste, closing the ecological and economic flows of resources. Thereby, this machine becomes essential for the continuation and proper development of such a research and social awareness project. The new version of the plastic shredder entails a solid design that meets the needs and requirements of the task assigned in its working environment, focusing on its design and manufacture from a sustainable point of view, reusing parts of the prototype itself, as well as other disused resources, mostly provided by the University of Malaga. This concept of sustainability even extends to its operation, controlling the consumption of the engine and paying special attention to durability, reliability and, above all, the safety of both, users and the shredder itself. Among other design priorities, the possibility to visualise and perfectly understand how and why the reused plastic passes through the shredder is one of the most important due to the educational purpose of the project towards a younger audience about circular economy. To achieve this, the machine should not only be able to show the process in an illustrative way, but also the interaction with the machine should be simple and fluid, without the need for previous knowledge or experience operating industrial machinery.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Management of acute diverticulitis with pericolic free gas (ADIFAS). an international multicenter observational study

Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II-IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4-64, P =0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2-19.9, P =0.023), with 88% of success compared to 96% without free fluid ( P <0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Análisis meteoceánico en BIMEP para el diseño de convertidores de energía marinos

El trabajo presentado se ha desarrollado en el marco del proyecto TRL +. TRL+ es un proyecto de investigación financiado por el Ministerio de Economía y Competitividad (MINECO) mediante el programa RETOS (RTC-2015-3836-3

­Tenemos correo!

Se usa el correo para animar a la lectura a los alumnos de Primaria. Es una forma de variar la presentación de las lecturas haciendo que resulten más atractivas para el alumnado. Estos reciben unas cartas muy especiales, se trata de unas lecturas secuenciadas que se presentan de diferentes formas y que inducen a los alumnos a participar en juegos de lectura, ya que en cada carta se les presenta una incógnita que tienen que resolver. Con esta actividad se mejora su actitud hacia la lectura, mejoran la entonación, el ritmo de la lectura en voz alta, la comprensión lectora y la expresión escrita. Además, esta actividad también repercute en un aumento del número de visitas de la biblioteca para buscar información. Se realizan actividades como escribir las respuestas a las cartas, elaborar cuestionarios, realizar dibujos y actividades de expresión plástica como murales, convertirse en espías y tener que buscar información en la biblioteca, en internet para resolver los jeroglíficos, juegos de palabras o adivinanzas. Adjunta ejemplos del material elaborado para el desarrollo de las actividades.Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Immunocompromised patients with acute respiratory distress syndrome: Secondary analysis of the LUNG SAFE database

Background: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. Methods: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents. Results: Of 2813 patients with ARDS, 584 (20.8%) were immunocompromised, 38.9% of whom had an unspecified cause. Pneumonia, nonpulmonary sepsis, and noncardiogenic shock were their most common risk factors for ARDS. Hospital mortality was higher in immunocompromised than in immunocompetent patients (52.4% vs 36.2%; p &lt; 0.0001), despite similar severity of ARDS. Decisions regarding limiting life-sustaining measures were significantly more frequent in immunocompromised patients (27.1% vs 18.6%; p &lt; 0.0001). Use of noninvasive ventilation (NIV) as first-line treatment was higher in immunocompromised patients (20.9% vs 15.9%; p = 0.0048), and immunodeficiency remained independently associated with the use of NIV after adjustment for confounders. Forty-eight percent of the patients treated with NIV were intubated, and their mortality was not different from that of the patients invasively ventilated ab initio. Conclusions: Immunosuppression is frequent in patients with ARDS, and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent patients, particularly the greater use of NIV as first-line ventilation strategy. Compared with immunocompetent subjects, they have higher mortality regardless of ARDS severity as well as a higher frequency of limitation of life-sustaining measures. Nonetheless, nearly half of these patients survive to hospital discharge. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

El periódico escolar como recurso para la comunicación, la participación y la animación a la lectura

Con este proyecto se pone en marcha una publicación cuatrimestral elaborada con aportaciones de todos los alumnos del centro. En esta revista escolar tienen cabida todos los sectores de la comunidad educativa para informar a las familias y para anunciar las actividades que se realizan en el centro. Entre los objetivos está el que los alumnos se sientan motivados en su trabajo diario por la posibilidad de que alguno de sus trabajos sea publicado en el periódico escolar. Además, con la publicación se pretende fomentar la observación y la creatividad entre los alumnos, que estos desarrollen el hábito lector, que valoren los trabajos de los compañeros y dar a conocer a toda la comunidad educativa las actividades que se desarrollan en el centro. Esta actividad también es muy positiva para fomentar la colaboración de los padres a través de la asociación de madres y padres de alumnos. El periódico está compuesto de secciones como creación literaria que recoge escritos de alumnos; un libro, un amigo, que contiene reseñas de libros que los alumnos recomiendan a sus compañeros; nuestro mundo; galería de arte; aprender con el periódico, donde se recogen trabajos de investigación de los alumnos; actividades dentro del centro; pasatiempos; entrevistas; una sección en inglés y otra de música. La publicación es maquetada y diseñada por los profesores. Adjunta un ejemplar del periódico.Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease