The Upper Paleolithic Rock Art of Iberia

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Are Aortic Root and Ascending Aorta Diameters Measured by the Pediatric versus the Adult American Society of Echocardiography Guidelines Interchangeable?

Aortic dimensions; Echocardiography; Guideline’s recommendationsDimensions aòrtiques; Ecocardiografia; Recomanacions de les directriusDimensiones aórticas; Ecocardiografía; Recomendaciones de las directricesAscending aorta diameters have important clinical value in the diagnosis, follow-up, and surgical indication of many aortic diseases. However, there is no uniformity among experts regarding ascending aorta diameter quantification by echocardiography. The aim of this study was to compare maximum aortic root and ascending aorta diameters determined by the diastolic leading edge (DLE) and the systolic inner edge (SIE) conventions in adult and pediatric patients with inherited cardiovascular diseases. Transthoracic echocardiograms were performed in 328 consecutive patients (260 adults and 68 children). Aorta diameters were measured twice at the root and ascending aorta by the DLE convention following the 2015 American Society of Echocardiography (ASE) adult guidelines and the SIE convention following the 2010 ASE pediatric guidelines. Comparison of the diameters measured by the two conventions in the overall population showed a non-significant underestimation of the diameter measured by the SIE convention at root level of 0.28 mm (CI −1.36; 1.93) and at tubular ascending aorta level of 0.17 mm (CI −1.69; 2.03). Intraobserver and interobserver variability were excellent. Maximum aorta diameter measured by the leading edge convention in end-diastole and the inner edge convention in mid-systole had similar values to a mild non-significant underestimation of the inner-to-inner method that permits them to be interchangeable when used in clinical practice

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

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND: Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVE: We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS: We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 ± 19.2 years) recruited from 29 international centers. RESULTS: At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% ± 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of ≤35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS: MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Predicción de la calidad fermentativa de ensilados de girasol mediante espectroscopía de reflectancia en el infrarrojo cercano (NIRS) sobre muestras secas

The objective of the present work was to evaluate the predictive ability of calibration equations developed by NIRS (near-infrared reflectance spectroscopy) on dry and ground samples for estimating the fermentative quality of sunflower silage. NIRS spectra of a total of 52 oven-dried and ground silage samples from different laboratory silo tests carried out at the Mabegondo Agricultural Research Center (Centro de Investigacións Agrarias de Mabegondo, CIAM) were registered. The fresh samples were analyzed using reference methods. The pH, lactic acid, acetic acid, ethanol, ammonia nitrogen and soluble nitrogen levels were determined. NIRS calibrations were developed by modified partial least squares regression, performing a regression between spectral and reference data. The predictive capacity of the equations obtained ranged from excellent to good, with cross-validation coefficients of determination (r2cv) equal to or above 0.88. The RPD index values for all the parameters studied were equal to or above 3.0; therefore, the calibration equations obtained on dry and ground samples can be used satisfactorily to predict the fermentative quality of sunflower silages in routine analyses.El objetivo del presente trabajo fue evaluar la capacidad de predicción de las ecuaciones de calibración desarrolladas mediante NIRS (espectroscopía de reflectancia en el infrarrojo cercano) sobre muestras secas y molidas, para estimar la calidad fermentativa de ensilados de girasol. Un total de 52 muestras de ensilados procedentes de diferentes ensayos de silos de laboratorio realizados en el CIAM (Centro de Investigacións Agrarias de Mabegondo), cuyo espectro NIRS se registró sobre muestras secas en estufa y molidas. Las muestras en estado fresco fueron analizadas por métodos de referencia. Se determinó el pH, ácido láctico, ácido acético, etanol, nitrógeno amoniacal y nitrógeno soluble. Las calibraciones NIRS fueron desarrolladas utilizando regresión por mínimos cuadrados parciales modificada, realizando la regresión entre los datos espectrales y los de referencia. La capacidad predictiva de las ecuaciones obtenidas osciló entre excelente y buena, mostrando coeficientes de determinación de validación cruzada (r2vc) iguales o superiores a 0.88. Los valores del índice RPD para todos los parámetros estudiados fueron iguales o superiores a 3.0, por lo tanto, las ecuaciones de calibración obtenidas sobre muestras secas y molidas pueden utilizarse satisfactoriamente para predecir la calidad fermentativa de ensilados de girasol en análisis de rutina

The Impact of University Collaborative Learning on Student Academic Achievement: A Wiki for Political and Management Science

El objetivo del proyecto es llevar a la práctica una acción formativa basada en la web 2.0 con la participación de profesores y alumnos pertenecientes a distintos grados, facultades y universidades. En concreto, esta iniciativa pretende continuar con la wiki, www.dcpa.wikidot.com, que comenzó a realizarse en 2015 en virtud de la convocatoria de PIMCD. La wiki contribuye a que los estudiantes, de manera colaborativa, diseñen un proyecto educativo de integración curricular a partir de unos supuestos establecidos previamente por el profesor. Por lo tanto, este tipo de experiencia permite crear una base documental de gran utilidad para otros alumnos que estudian este tipo de asignaturas o para cualquier persona que muestren una inquietud o necesidad de buscar, encontrar o ampliar el conocimiento sobre determinadas cuestiones relacionadas con la Ciencia Política y la Ciencia de la Administración. Además, este año vamos a incorporar al proyecto de innovación la creación de un blog, como una experiencia piloto, en una de las asignaturas de los profesores del equipo. De esta manera, se continúa avanzando en el aprendizaje colaborativo, así como en la interacción entre el profesor y el alumno. El blog, al igual que la wiki, permite difundir de lo que ocurre en el aula al resto de la sociedad, contribuyendo a la transferencia del conocimiento. La razón principal de haber elegido estas herramientas es que este tipo de aplicaciones, bajo la estructura de un procesador de texto en línea, permite que cualquier persona pueda escribir, publicar fotografías o vídeos, archivos o links, sin ninguna complejidad. Además, contribuye a renovar las metodologías de enseñanza, ya que favorece el aprendizaje colaborativo (el conocimiento se comparte) y refuerza la relación de confianza entre profesor-alumno, ya que el estudiante adquiere un rol activo en el proceso de recopilación, análisis y difusión de conocimiento. De este modo, el estudiante adquiere competencias y habilidades de una manera dinámica. No obstante, para que las tecnologías generen valor en los procesos de enseñanza-aprendizaje es necesario que los profesores nos centremos en diseñar unas experiencias de aprendizaje adaptadas a ellas. Solo de esta manera, la wiki y el blog pueden contribuir a la construcción del conocimiento y a la resolución de problemas de manera progresiva y evolutiva, de fomento de la capacidad crítica, evaluación de la información y el cuestionamiento de la realidad, y compromiso por un análisis equilibrado del trabajo de otros y contra los prejuicios. Por tal motivo, se presentará a los estudiantes una serie de pautas que deberán seguir para su buen desarrollo. En cuanto a la wiki, en primer lugar, se explicará el programa de la asignatura y se les indicarán que podrán desarrollar analíticamente cualquier concepto o acontecimiento que guarde relación con la misma, y en segundo lugar, se les señalara que deberán formar un grupo de 4 personas para poder llevar a cabo tal tarea, y que, una vez que determinen el tema a trabajar, deberá concretarlo con la profesora para evitar duplicidades y recibir los fundamentos sobre las cuales deberán vertebrar sus trabajos. En cuanto al blog, se expondrá a los alumnos de la asignatura de “Sistema político español”, que se creará una bitácora común para toda la clase en la que los mismos grupos de la wiki publicar una noticia, un video, una nota de prensa, etc relacionada con cada tema de la asignatura, y además deberán comentar esta aportación y vincularla con la parte teórica. Así, la innovación docente que se pretende conseguir es fomentar el trabajo colaborativo dentro y fuera del aula. En la actualidad, la wiki cuenta con 308 conceptos, por lo que esta iniciativa contribuirá a ampliar la información y el conocimiento sobre la Ciencia Política y la Ciencia de la Administración, incrementado, así, su repercusión, al igual que el blog. Con ello, los alumnos aprenderán a trabajar en grupo y de forma ordenada y continuada, además de adquirir una serie de herramientas que podrán ser empleadas en otras asignaturas y aspectos de su vida personal y profesional. Además, se medirá y evaluará su rendimiento académico para conocer si esta nueva metodología de aprendizaje permite mejorar los resultados de los estudiantes. Gracias a ello, los profesores podrán proponer nuevas herramientas docentes que tiendan a dirigir a los estudiantes hacia aquél enfoque de aprendizaje que proporcione mejor rendimiento.The aim of the project is to implement a training action based on web 2.0 with the participation of teachers and students belonging to different degrees, faculties and universities. Specifically, this initiative aims to continue with the wiki, www.dcpa.wikidot.com, which began to be carried out in 2015 under the PIMCD call for proposals. The wiki helps students, in a collaborative manner, to design an educational project of curricular integration based on assumptions previously established by the teacher. Therefore, this type of experience makes it possible to create a very useful documentary base for other students studying this type of subject or for anyone who shows an interest or need to search for, find or expand knowledge on certain issues related to Political Science and Management Science. In addition, this year we are going to incorporate into the innovation project the creation of a blog, as a pilot experience, in one of the subjects taught by the team's lecturers. In this way, we continue to make progress in collaborative learning, as well as in the interaction between teacher and student. The blog, like the wiki, allows the dissemination of what happens in the classroom to the rest of society, contributing to the transfer of knowledge. The main reason for choosing these tools is that this type of application, under the structure of an online word processor, allows anyone to write, publish photographs or videos, files or links, without any complexity. Moreover, it contributes to renew teaching methodologies, as it favours collaborative learning (knowledge is shared) and reinforces the relationship of trust between teacher-student, as the student acquires an active role in the process of gathering, analysing and disseminating knowledge. In this way, the student acquires competences and skills in a dynamic way. However, for technologies to generate value in the teaching-learning process, it is necessary for teachers to focus on designing learning experiences adapted to them. Only in this way can the wiki and the blog contribute to the construction of knowledge and problem solving in a progressive and evolutionary way, fostering critical capacity, evaluation of information and questioning of reality, and commitment to a balanced analysis of the work of others and against prejudices. For this reason, students will be presented with a series of guidelines to follow for its proper development. As for the wiki, firstly, the syllabus of the subject will be explained and they will be told that they will be able to analytically develop any concept or event related to it, and secondly, they will be told that they will have to form a group of 4 people to carry out this task, and that, once they have determined the topic to work on, they should discuss it with the teacher to avoid duplication and to receive the foundations on which they should base their work. As for the blog, it will be explained to the students of the subject "Spanish political system" that a common blog will be created for the whole class in which the same wiki groups will publish a news item, a video, a press release, etc. related to each subject of the course, and they will also have to comment on this contribution and link it to the theoretical part. In this way, the teaching innovation that is intended to be achieved is to encourage collaborative work inside and outside the classroom. At present, the wiki has 218 concepts, so this initiative will contribute to expanding information and knowledge about Political Science and Administration Science, thus increasing its impact, just like the blog. In this way, students will learn to work in groups and in an orderly and continuous manner, as well as acquiring a series of tools that can be used in other subjects and aspects of their personal and professional lives. In addition, their academic performance will be measured and evaluated to find out whether this new learning methodology improves students' results. As a result, teachers will be able to propose new teaching tools that tend to direct students towards the learning approach that provides the best performance.Depto. de Ciencia Política y de la AdministraciónFac. de Ciencias Políticas y SociologíaFALSEUCMsubmitte

3er. Coloquio: Fortalecimiento de los Colectivos de Docencia

Las memorias del 3er. Coloquio de Fortalecimiento de Colectivos de Docencia deben ser entendidas como un esfuerzo colectivo de la comunidad de académicos de la División de Ciencias y Artes para el Diseño, en medio de la pandemia COVID-19, con el fin de: • Analizar y proponer acciones concretas que promuevan el mejoramiento de la calidad docente en la División. • Proponer acciones que permitan continuar fortaleciendo los cursos con modalidad a distancia (remotos). • Ante un escenario que probablemente demandará en el mediano plazo, transitar del modelo remoto a un modelo híbrido, proponer acciones a considerar para la transición de los cursos. • Planear y preparar cursos de nivelación de conocimientos, para cuando se transite a la impartición de la docencia de manera mixta o presencial, dirigidos a los alumnos que no hayan tenido oportunidad de desarrollar actividades relevantes para su formación, como prácticas de talleres y laboratorios, visitas, o alguna otra actividad relevante