33 research outputs found
Descomposición de la capa de hojarasca de diferentes especies perennifolias y caducifolias
Las hojarascas de las especies caducifolias y perennifolias presentan procesos
diferenciales de descomposición, debidos, en gran parte, a las diferencias en
su composición químic
Revista de Vertebrados de la Estación Biológica de Doñana
Clave preliminar de las escamas de los peces de agua dulce de España, a nivel de familiaExito reproductor del Buitre leonado (Gyps fulvus) en NavarraAlimentación del Gavilán (Accipiter nisus) en la Isla de TenerifeEl Verdecillo (Serinus serinus): Tendencias en la estación de nidificación, en el tamaño del huevo y en la supervivencia.las batidas como método de censo en especiesde caza mayor: aplicación al caso del Jabalí (Sus scrofa L.) en la provincia de Burgos (Norte de España)La adquisición de madurez sexual en el camaleón común (Chamaeleo chamaeleon)Nuevas citas de Hemidactylus turcicus en la provincia de CáceresLa focha común (Fulica atra) en la isla de Gran Canaria: nueva especie nidificante en el archipiélago CanarioTraslado de huevos en incubación por la urraca (Pica pica)Predación de Falco peregrinus sobre Oryctolagus cuniculusCuatro nuevas especies de aves para Bolivia.Sobre la utilización de nidos de golondrina común abandonados.Parasitismo múltiple del críalo (Clamator glandarius)Predación del topo de rio (Galemys pyrenaicus, Geoffroy 1811) por parte de la lechuza común (Tyto alba, Scopoli 1769)Predación del zorro (Vulpes vulpes) sobre un pollo de buitre leonado (Gyps fulvus).Vulpes vulpes L. criando en una colonia de marmota (Marmota marmota L.) en el pirineo de LéridaObservaciones sobre la incidencia de Rattus (Fischer, 1803) en los cultivos ibéricos de caña de azúcaSituación actual de la jutiita de la tierra Capromys sanfelipensis (Rodentia, Mammalia)Notas sobre la intraducción y expansión de la ardilla común en Sierra Nevada, sureste de EspañaPeer reviewe
Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters
This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe
Die Rolle von Batf3-abhängigen dendritischen Zellen und des IL-23-Rezeptors in der Atherosklerose
Cardiovascular diseases represent the leading cause of death worldwide, with myocardial infarction and strokes being the most common complications. In both cases, the appearance of an enlarged artery wall as a consequence of a growing plaque is responsible for the disturbance of the blood flow. The formation of plaques is driven by a chronic inflammatory condition known as atherosclerosis, characterized by an initial step of endothelial cell (EC) dysfunction followed by the recruitment of circulating immune cells into the tunica intima of the vessel. Accumulation of lipids and cells lead to the formation of atheromatous plaques that will define the cardiovascular outcome of an individual.
The role of the immune system in the progression of atherosclerosis has been widely recognized. By far, macrophages constitute the most abundant cell type in lesions and are known to be the major source of the lipid-laden foam cell pool during the course of the disease. However, other immune cells types, including T cells, dendritic cells (DCs) or mast cells, among others, have been described to be present in human and mouse plaques. How these populations can modulate the atherogenic process is dependent on their specialized function.
DCs constitute a unique population with the ability to bridge innate and adaptive immune responses, mainly by their strong capacity to present antigens bound to a major histocompatibility complex (MHC) molecule. Given their ability to polarize T cells and secrete cytokines, their role in atherosclerosis has gained attention for the development of new therapeutic approaches that could impact lesion growth. Hence, knowing the effect of a specific subset is an initial key step to evaluate its potential for clinical purposes. For example, the basic leucine zipper ATF-like 3 transcription factor (Batf3) controls the development of conventional dendritic cells type 1 (cDCs1), characterized by the expression of the surface markers CD8 and CD103. Initially, they were described to promote both T-helper 1 (Th1) and regulatory T cell (Treg) responses, known to accelerate and to protect against atherosclerosis, respectively. The first part of this thesis aimed to elucidate the potential role of Batf3-dependent DCs in atherosclerosis and concluded that even though systemic immune responses were mildly altered they do not modify the course of the disease and may not represent an attractive candidate for clinical studies.
DCs also have the ability to impact lesion growth through the release of a broad range of cytokines, which can either directly impact atherosclerotic plaques by modulating resident cells, or by further polarizing T cell responses. Among others, interleukin (IL) 23, a member of the IL-12 family of cytokines, has received much attention during the past year due to its connection to autoimmunity.
IL-23 is known to induce pathogenicity of Th17 cells and is responsible for the development of several autoimmune diseases including multiple sclerosis, psoriasis or rheumatoid arthritis. Interestingly, these patients often present with an accelerated course of atherosclerosis and thus, are at higher risk of developing cardiovascular events. Several epidemiological studies have pointed toward a possible connection between IL-23 and its receptor IL-23R in atherosclerosis, although their exact contribution remains to be elucidated. The second part of this thesis showed that resident antigen-presenting cells (APCs) in the aorta produced IL-23 during the steady state but this secretion was greatly enhanced after incubation with oxidized low-density lipoprotein (oxLDL). Furthermore, disruption of the IL-23R signaling led to decreased relative necrotic plaque area in lesions of Ldlr-/-Il23r-/- mice fed a high-fat diet (HFD) for 6 and 12 weeks compared to Ldlr-/- controls. A proposed mechanism involves that increased IL-23 production in the context of atherosclerosis may promote the pathogenicity of IL-23-responding T cells, especially IL-23R+ γδ T cells in the aortic root. Response to IL-23 might increase the release of granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-17 and alter the pro- and anti-inflammatory balance of cytokines in the aortic root. Altogether, these data showed that the IL-23 / IL-23R axis play a role in plaque stability.Kardiovaskuläre Erkrankungen sind weltweit die häufigste Todesursache, wobei Myokardinfarkt und Schlaganfall die häufigsten Komplikationen darstellen. In beiden Fällen ist das Auftreten einer verbreiterten Arterienwand als Folge eines wachsenden Plaques für die Störung des Blutflusses verantwortlich. Die Bildung von Plaques wird durch einen chronischen Entzündungszustand, bekannt als Atherosklerose, ausgelöst. Zunächst kommt es dabei zur Entstehung einer endothelialen Dysfunktion, die zur Rekrutierung zirkulierender Immunzellen in die Tunica Intima des Gefäßes führt. Die Akkumulation von Lipiden und Zellen wiederum führt zur Bildung von atheromatösen Plaques, die den kardiovaskulären Gefäßstatus eines Individuums bestimmen.
Die Rolle des Immunsystems bei der Progression der Atherosklerose wurde weithin anerkannt. Makrophagen stellen bei weitem den häufigsten Zelltyp innerhalb der Läsionen dar und sind bekanntermaßen die Hauptquelle des mit Lipid beladenen Schaumzellpools im Verlauf der Erkrankung. Es wurde jedoch auch beschrieben, dass andere Arten von Immunzellen, einschließlich der T-Zellen, dendritischen Zellen (DCs) und Mastzellen, in humanen und murinen Plaques vorhanden sind. Wie diese Populationen den atherogenen Prozess modulieren können, hängt von ihrer spezialisierten Funktion ab.
DCs bilden eine einzigartige Population, der es möglich ist, angeborene und adaptive Immunartworten zu überbrücken. Dies geschieht hauptsächlich aufgrund ihrer ausgeprägten Fähigkeit, Antigene zu präsentieren, die an einen Haupthistokompatibilitätskomplex gebunden sind. Angesichts ihrer Rolle in der Polarisierung von T-Zellen und der Sezernierung von Zytokinen haben sie bisher Aufmerksamkeit bei der Entwicklung neuer therapeutischer Ansätze zur Beeinflussung des Läsionswachstums erlangt. Die Kenntnis der Wirkung einer bestimmten Subpopulation ist ein erster wichtiger Schritt, um ihr Potenzial für klinische Zwecke zu bewerten. Zum Beispiel steuert der Transkriptionsfaktor „basic leucine zipper ATF-like 3“ (Batf3) die Entwicklung von herkömmlichen dendritischen Zellen Typ 1, welche durch die Expression der Oberflächenmarker CD8 und CD103 gekennzeichnet sind. Anfänglich wurde beschrieben, dass sie sowohl die Antworten von T-Helfer 1 als auch von regulatorischen T-Zellen fördern, welche je nach Zellfunktion die Atherosklerose beschleunigen oder vorbeugen. Im ersten Teil dieser Arbeit wurde die potentielle Rolle von Batf3-abhängigen DCs für die Entstehung der Atherosklerose aufgeklärt. Trotz diese einer leichten Veränderungen der systemischen Immunantwort den Krankheitsverlauf nicht beeinflussen und daher keine attraktiven Kandidaten für klinische Studien darstellen.
DCs haben auch die Fähigkeit das Läsionswachstum durch Freisetzung einer breiten Palette an Zytokinen zu beeinflussen, die atherosklerotische Plaques entweder direkt durch Modulation von ortsständigen residenten Zellen oder durch weiteres Polarisieren von T-Zell-Reaktionen beeinflussen können. Unter anderem hat interleukin (IL) 23, ein Mitglied der IL-12-Zytokinfamilie, aufgrund seines Zusammenhangs mit Auto-immunität im vergangenen Jahr viel Aufmerksamkeit erhalten.
Es ist bekannt, dass IL-23 die Pathogenität von Th17-Zellen induziert und für die Entwicklung von mehreren Autoimmunkrankheiten einschließlich multipler Sklerose, Psoriasis oder rheumatoider Arthritis verantwortlich ist. Interessanterweise haben alle diese Erkrankungen gemeinsam, dass sie die Entstehung einer Atherosklerose beschleunigen. Die betroffenen Patienten haben ein höheres Risiko für ein kardiovaskuläres Ereignis. Mehrere epidemiologische Studien haben auf einen möglichen Zusammenhang zwischen IL-23 und seinem Rezeptor IL-23R bei Atherosklerose hingewiesen, auch wenn die genaue Relevanz dieser Hinweise noch zu klären ist. Im zweiten Teil dieser Arbeit konnte es gezeigt werden, dass ortsständige antigenpräsentierende Zellen in der Aorta IL-23 zwar bereits im Steady State produzieren, diese Sekretion jedoch nach Inkubation mit oxLDL stark erhöht ist. Darüber hinaus führte eine Störung der IL-23R-Signalgebung nach 6 bis 12 Wochen einer fettreichen Diät (HFD) zu einer verringerten relativen nekrotischen Plaque-Fläche in Läsionen von Ldlr-/-Il23r-/- Mäusen verglichen mit Ldlr-/- Mäusen. In Bezug auf den zugrunde liegenden Mechanismus wurde diskutiert, dass eine erhöhte IL-23-Produktion im Zusammenhang mit Atherosklerose die Pathogenität von IL-23R-reaktiven T-Zellen, insbesondere von IL-23R+ γδ T-Zellen in der Aortenwurzel, fördern kann. Reaktionen auf IL-23 könnten die Freisetzung von Granulozyten-Monozyten-Kolonie-stimulierendem Faktor und IL-17 erhöhen und das pro- und antiinflammatorische Gleichgewicht von Zytokinen innerhalb der Aortenwurzel verändern. Insgesamt zeigen diese Daten, dass die IL-23 / IL-23R Achse eine wichtige Rolle in der Etablierung der Plaquestabilität einnimmt
La educación artística como instrumento de integración intercultural y social
Este documento tiene su origen en el curso de formación del profesorado: La educación artística como instrumento de integración intercultural y social. Ávila, 2006Se considera que la cultura no es solo la manifestación intelectual que se expresa en el pensamiento. La cultura se manifiesta también en el arte y en gestos sencillos de la vida cotidiana. Dirigido a profesores de ESO. Se trata de proporcionar, tanto a la diversidad cultural como a la social del alumnado, una revisión pedagógica y metodológica en aquellas áreas que son ejes vertebradores de la interculturalidad como dimensión dinámica del proceso educativo.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín 5 -3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]
Using a Human Interviewer or an Automatic Interviewer in the Evaluation of Patients with AD from Speech
Currently, there are more and more frequent studies focused on the evaluation of Alzheimer’s disease (AD) from the automatic analysis of the speech of patients, in order to detect the presence of the disease in an individual or for the evolutionary control of the disease. However, studies focused on analyzing the effect of the methodology used to generate the spontaneous speech of the speaker who undergoes this type of analysis are rare. The objective of this work is to study two different strategies to facilitate the generation of the spontaneous speech of a speaker for further analysis: the use of a human interviewer that promotes the generation of speech through an interview and the use of an automatic system (an automatic interviewer) that invites the speaker to describe certain visual stimuli. In this study, a database called Cross-Sectional Alzheimer Prognosis R2019 has been created, consisting of speech samples from speakers recorded using both methodologies. The speech recordings have been studied through a feature extraction based on five basic temporal measurements. This study demonstrates the discriminatory capacity between the speakers with AD and the control subjects independent of the strategy used in the generation of spontaneous speech. These results are promising and can serve as a basis for knowing the effectiveness and extension of automated interview processes, especially in telemedicine and telecare scenarios
Classification of antineoplastic drug-induced tissue damage: a Consensus of the Spanish Oncology Pharmacy Group
Objetivo: Realizar un consenso de expertos utilizando el método Delphi para la clasificación del potencial de daño tisular de los antineoplásicos que facilite la toma de decisiones ante una extravasación. Método: El panel de evaluadores estaba formado por siete farmacéuticos del grupo de trabajo de extravasaciones. Otro actuó como coordinador. Se revisó la probabilidad de daño tisular a partir de ocho documentos de referencia. Se clasificaron en cuatro categorías: vesicante, irritante de alto riesgo, irritante de bajo riesgo y no irritante. Se realizaron dos rondas; tras éstas los fármacos con consenso 85% y del 100%. Se analizaron de forma separada los fármacos con discordancias de clasificación entre los documentos consultados. Se utilizó el programa
estadístico SPSS v23.0. Resultados: Se evaluaron 71 antineoplásicos. En la primera ronda la mediana del grado de consenso fue 100% (AIQ25-75: 71,4-100,0%) y en la segunda ronda 100% (AIQ25-75: 85,7-100,0%). El porcentaje de antineoplásicos con consenso ≥ 85,7% aumentó del 66,7% al 85,9% en la segunda ronda. Para los 30 antineoplásicos con discrepancias entre los documentos revisados, el grado de consenso aumentó del 71,4% (AIQ25-75: 57,1-87,7%) al 100% (AIQ25-75: 85,7-100,0%) en la segunda ronda. El porcentaje de antineoplásicos con concordancia ≥ 85,7% pasó del 40,0% al 76,7%. Cuatro antineoplásicos presentaron consenso 85%, y para el 74% de los antineoplásicos la concordancia fue del 100%, aportando una base sólida para las decisiones de manejo.Objective: To reach at an expert consensus, using the Delphi method, for classifying the tissue-damaging potential of antineoplastic drugs, in order to facilitate the decision-making process in the event of extravasations. Method: The panel of expert evaluators was made up of seven pharmacists belonging to the working group on extravasations. Other member served as coordinator. The likelihood of tissue damage was reviewed on the basis of eight reference documents. Four categories of drugs were established: vesicant (V); high risk irritant (HRI); low risk irritant (LRI) and non-irritant (NI). Two rounds of surveys were performed. The drugs with an agreement of less than 70% after the two rounds were discussed non-anonymously by the group. For each of the rounds the following was analysed: median of the degree of consensus and the interquartile range (IQR25-75), degree of agreement by tissue damage category, and percentage of antineoplastics reaching a degree of consensus of over 85% and of 100%. Drugs whose classification differed in the various reference documents were assessed separately. SPSS v23.0 statistical software was used. Results: Seventy-one antineoplastics were evaluated. In the first round, the median for degree of consensus was 100.0% (IQR25-75: 71.4- 100.0%). In the second round, the median was 100.0% (IQR25-75: 85.7- 100.0%). The percentage of antineoplastics with a consensus of 85.7% or above increased from 66.7% to 85.9% in the second round. For the 30 antineoplastics whose values differed in the reference documents, the degree of agreement increased from 71.4% (IQR25-75: 57.1-87.7%) to 100.0% (IQR25-75: 85.7-100.0%) in the second round. The percentage of antineoplastics with a consensus of 85.7% or above increased from 40.0% to 76.7%. Four antineoplastics had a degree of agreement of less than 70.0%. The final classification of drugs per category, was: 17 vesicants; 15 HRI; 13 LRI; and 26 NI. The final degree of consensus was 85.7% or above for 90.1% of antineoplastics, and 100.0% for 74.6% of the same. Conclusions: In this area of scarce evidence and high variability, the Delphi method allows for consensus in classifying tissue damage risk, thus making it easier to reach clinical decisions. In approximately 90% of the antineoplastics, the degree of consensus reached by the expert panel was 85% or above. In 74% of the antineoplastics, it was 100%. This provides solid ground for management decisions
Mi amigo el ajedrez en un C.E.E
Convocatoria Proyectos de innovación de Extremadura 2018/2019Proyecto llevado a cabo en el CEE Casa de la Madre de Mérida (Badajoz) dirigido a alumnos mayoritariamente plurideficientes, algunos con rasgos autistas, o con otros síntomas específicos, y todos ellos con déficit cognitivo y con problemas conductuales, de impulsividad, etc. Se plantea con una doble vertiente, por un lado como un programa de aprendizaje de ajedrez básico que gira en torno al conocimiento del juego, el tablero, las piezas, su colocación, etc. y, por otro lado, desde un punto de vista terapéutico, para entrenar áreas cognitivas concretas como la memoria, la atención, el razonamiento lógico, etc. Los principales objetivos del proyecto son: potenciar las habilidades sociales de los alumnos, educar en valores (tolerancia, compañerismo, humildad, etc.) y mejorar las habilidades mentales (aumentar la memoria, la capacidad de análisis y reflexión, la concentración, la atención, etc.)ExtremaduraES
Antineoplastic extravasation management: consensus of the Spanish Oncology Pharmacy Group (GEDEFO)
Data de publicació electrónica: 26-04-202