Reflexión de competencias

Treball Final del Màster Universitari en Psicologia del Treball, de les Organitzacions i en Recursos Humans (Pla de 2014) (Presencial). Codi: SBE013. Curs acadèmic 2014-2015El presente trabajo pretende abordar una visión personal, una reflexión acerca de la asunción y desarrollo de las distintas competencias que el máster en Psicología del Trabajo, en las Organizaciones y Recursos Humanos considera relevantes de cara al futuro profesional de un psicólogo del Trabajo o un profesional de Recursos Humanos. Este trabajo comienza con la presentación de las asignaturas que conforman el citado máster. Cada una de ellas y todas consideradas en su conjunto son las herramientas que permiten el desarrollo de las competencias sobre las que se reflexiona, una reflexión que conforma el grueso del trabajo y que se inicia en el siguiente apartado. En concreto, se trata de analizar el grado inicial que el estudiante tenía antes de su paso por el máster y el grado que considera que tiene actualmente, prestando especial atención a los ejercicios, actividades u otras herramientas que han promovido el desarrollo de las distintas competencias. El trabajo finaliza con una reflexión holística, especificando los aspectos positivos y los que pueden ser mejorables además de qué podemos extraer de las competencias desarrolladas. Por último, se analiza qué o cómo podría haberse contribuido más a su asunción y en qué medida éstas pueden ser de utilidad en nuestro futuro profesional.This work is intended to address a personal vision, a reflection on the assumption and development of individual skills that master in Psychology of work, Organizations and Human Resources considers relevant face to the career of a work psychologist or human resources professional. This work begins with the presentation of the subjects that make up the aforementioned master. Each one of them and all considered as a whole, are tools that allow the development of competencies about we reflect, a reflection which constitutes the bulk of the work that begins in the next section. In particular, it is analysed the initial grade that the student had before passing through the master and the grade he considers that it has at present, paying special attention to the exercises, activities or other tools that have promoted the development of these skills. The work ends with a holistic reflection, specifying the positive aspects and those that can be improved and what can we get from the developed competencies. Finally, it discusses about what or how the master could have contributed the most to its assumption and to what extent these can be useful in our professional future

Bionanocompósitos de carragenina κ con nanopartículas metálicas

En este trabajo se reporta la preparación de nanocompósitos a base de biopoliméricos de Carragenina tipo κ con nanopartículas metálicas de plata y oro. La síntesis de las nanopartículas se llevó a cabo in situ en presencia de Carragenina κ, seguida del secado de la dispersión coloidal por liofilización para la obtención de los nanocompósitos. La morfología de los nanocompósitos y de las nanopartículas fue analizada por microscopía electrónica de barrido (MEB) y microscopía electrónica de transmisión (MET). Las propiedades ópticas se evaluaron mediante espectroscopía de UV-vis mientras que la caracterización estructural se llevó a cabo mediante espectroscopía de infrarrojo. Las propiedades térmicas se estudiaron mediante calorimetría diferencial de barrido (CDB). Los resultados muestran nanocompósitos con propiedades ópticas similares a las NP metálicas y con propiedades térmicas mejoradas. Estos nanocompósitos presentan potenciales aplicación como soporte biodegradable

Characterization of the platelet phenotype caused by a germline RUNX1 Variant in a CRISPR/Cas9-generated murine model

RUNX1-related disorder (RUNX1-RD) is caused by germline variants affecting the RUNX1 gene. This rare, heterogeneous disorder has no specific clinical or laboratory phenotype, making genetic diagnosis necessary. Although international recommendations have been established to classify the pathogenicity of variants, identifying the causative alteration remains a challenge in RUNX1-RD. Murine models may be useful not only for definitively settling the controversy about the pathogenicity of certain RUNX1 variants, but also for elucidating the mechanisms of molecular pathogenesis. Therefore, we developed a knock-in murine model, using the CRISPR/Cas9 system, carrying the RUNX1 p.Leu43Ser variant (mimicking human p.Leu56Ser) to study its pathogenic potential and mechanisms of platelet dysfunction. A total number of 75 mice were generated; 25 per genotype (RUNX1WT/WT, RUNX1WT/L43S, and RUNX1L43S/L43S). Platelet phenotype was assessed by flow cytometry and confocal microscopy. On average, RUNX1L43S/L43S and RUNX1WT/L43S mice had a significantly longer tail-bleeding time than RUNX1WT/WT mice, indicating the variant's involvement in hemostasis. However, only homozygous mice displayed mild thrombocytopenia. RUNX1L43S/L43S and RUNX1WT/L43S displayed impaired agonist-induced spreading and α-granule release, with no differences in δ-granule secretion. Levels of integrin αIIbβ3 activation, fibrinogen binding, and aggregation were significantly lower in platelets from RUNX1L43S/L43S and RUNX1WT/L43S using phorbol 12-myristate 13-acetate (PMA), adenosine diphosphate (ADP), and high thrombin doses. Lower levels of PKC phosphorylation in RUNX1L43S/L43S and RUNX1WT/L43S suggested that the PKC-signaling pathway was impaired. Overall, we demonstrated the deleterious effect of the RUNX1 p.Leu56Ser variant in mice via the impairment of integrin αIIbβ3 activation, aggregation, α-granule secretion, and platelet spreading, mimicking the phenotype associated with RUNX1 variants in the clinical setting.This work was partially supported by grants from Instituto de Salud Carlos III (ISCIII) and Feder (PI17/01311, PI17/01966, and CB15/00055), Fundación Séneca (19873/GERM/15), Gerencia Regional de Salud (GRS 2061A/19 and 1647/A/17), Fundación Mutua Madrileña (FMM, AP172142019), and Sociedad Española de Trombosis y Hemostasia (SETH-FETH; Premio López Borrasca 2019 and Ayuda a Grupos de Trabajo en Patología Hemorrágica 2019). The authors' research on IPDs is conducted in accordance with the aims of the Functional and Molecular Characterization of Patients with Inherited Platelet Disorders Project, which is supported by the Hemorrhagic Diathesis Working Group of the Spanish Society of Thrombosis and Haemostasis. A.M.-Q., C.F.-I., and L.H.-C. were supported by predoctoral grants from the Junta de Castilla y León, Spain. E.V. was supported by the predoctoral grant from the University of Salamanca, Spain. IG-T and RB were supported by "Contratos postdoctorales Programa II) from the University of Salamanca, Spain

C3G, through its GEF activity, induces megakaryocytic differentiation and proplatelet formation

[Background]: Megakaryopoiesis allows platelet formation, which is necessary for coagulation, also playing an important role in different pathologies. However, this process remains to be fully characterized. C3G, an activator of Rap1 GTPases, is involved in platelet activation and regulates several differentiation processes. [Methods]: We evaluated C3G function in megakaryopoiesis using transgenic mouse models where C3G and C3GΔCat (mutant lacking the GEF domain) transgenes are expressed exclusively in megakaryocytes and platelets. In addition, we used different clones of K562, HEL and DAMI cell lines with overexpression or silencing of C3G or GATA-1. [Results]: We found that C3G participates in the differentiation of immature hematopoietic cells to megakaryocytes. Accordingly, bone marrow cells from transgenic C3G, but not those from transgenic C3GΔCat mice, showed increased expression of the differentiation markers CD41 and CD61, upon thrombopoietin treatment. Furthermore, C3G overexpression increased the number of CD41+ megakaryocytes with high DNA content. These results are supported by data obtained in the different models of megakaryocytic cell lines. In addition, it was uncovered GATA-1 as a positive regulator of C3G expression. Moreover, C3G transgenic megakaryocytes from fresh bone marrow explants showed increased migration from the osteoblastic to the vascular niche and an enhanced ability to form proplatelets. Although the transgenic expression of C3G in platelets did not alter basal platelet counts, it did increase slightly those induced by TPO injection in vivo. Moreover, platelet C3G induced adipogenesis in the bone marrow under pathological conditions. [Conclusions]: All these data indicate that C3G plays a significant role in different steps of megakaryopoiesis, acting through a mechanism dependent on its GEF activity.This work was supported by grants from the Spanish Ministry of Economy and Competitiveness [SAF2013–48210-C2–1-R and SAF2016–76588-C2–2-R to CG, SAF2013–48210-C2–2-R and SAF2016–76588-C2–1-R to AP], and by two grants from the Council of Education of Junta de Castilla y León, Spain [SA157A12–1 and SA017U16 to CG]. All funding was cosponsored by the European FEDER Program

Análisis fitoquímico y actividad antidiabética, antibacteriana y antifúngica de hojas de Bursera simaruba (Burseraceae)

Background and Aims: Bursera simaruba leaves are traditionally used to treat various illnesses. Nonetheless, there are few reports on the description of the phytochemicals potentially responsible for such biological activities. Therefore, this study aimed to describe the antifungal, antibacterial, and antidiabetic potential by using in vitro experiments, and to contribute to the knowledge of the chemical composition of B. simaruba leaves. Methods: A methanolic extract (MeOH-Ex) of B. simaruba leaves was tested for antibacterial, antifungal, and antidiabetic activities, and different groups of secondary metabolites were detected by qualitative assays. Furthermore, phytochemical analysis of MeOH-Ex was carried out by ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-ESI+-MS-QTOF), and putative identifications were performed using public spectral databases. Key results: The MeOH-Ex of the leaves of B. simaruba qualitatively contains alkaloids, terpenes and steroids, saponins, tannins, coumarins and phenolic compounds, such as caffeic acid, chlorogenic acid, apigenin, kaempferol, phlorizin, quercitrin, quercetin-glucoside and apigenin-glycoside. In addition, burseran and yatein lignans were tentatively identified. MeOH-Ex exhibited low antifungal activity against Fusarium solani (16.3% mycelial growth inhibition) and a high antidiabetic effect by in vitro inhibition of α-amylase (87.7%) and α-glucosidase (75.9%) enzymes. Finally, chlorogenic acid standard exhibited a significant inhibition of α-amylase (49.5%) and α-glucosidase (85.1%) enzymes. Conclusions: The MeOH-Ex of B. simaruba leaves represents a source of secondary metabolites with potential antidiabetic activity. The phenolic compounds tentatively identified could play important roles in preventing disorders due to post-prandial hyperglycemia by inhibiting the enzymes α-amylase and α-glucosidase. Chlorogenic acid presence is highlighted as one of the main potential bioactive compounds in B. simaruba leaves.Antecedentes y Objetivos: Las hojas de Bursera simaruba se utilizan tradicionalmente para tratar diversas enfermedades. Sin embargo, existen pocos reportes sobre la descripción de los fitoquímicos potencialmente responsables de tales actividades biológicas. Por lo tanto, este estudio tuvo como objetivo describir el potencial antifúngico, antibacteriano y antidiabético mediante experimentos in vitro, así como contribuir al conocimiento de la composición química de las hojas de B. simaruba. Métodos: Se analizó la actividad antibacteriana, antifúngica y antidiabética de un extracto metanólico (MeOH-Ex) de hojas de B. simaruba, y se detectaron diferentes grupos de metabolitos secundarios mediante ensayos cualitativos. Además, el análisis fitoquímico de MeOH-Ex se determinó con cromatografía líquida de ultra alta resolución acoplada a espectrometría de masas de alta resolución (UHPLC-ESI+-MS-QTOF), y las identificaciones putativas se realizaron utilizando bases de datos espectrales públicas. Resultados clave: El MeOH-Ex de las hojas de B. simaruba contiene cualitativamente alcaloides, terpenos y esteroides, saponinas, taninos, cumarinas y compuestos fenólicos, tales como ácido cafeico, ácido clorogénico, apigenina, kaempferol, florizina, quercitrina, quercetina-glucósido y apigenina-glucósido. Además, se identificaron tentativamente los lignanos burseran y yatein. El MeOH-Ex exhibió una baja actividad antifúngica contra Fusarium solani (16.3% de inhibición del crecimiento micelial) y un alto efecto antidiabético por inhibición in vitro de las enzimas α-amilasa (87.7%) y α-glucosidasa (75.9%). Finalmente, el estándar de ácido clorogénico mostró una inhibición significativa de las enzimas α-amilasa (49.5%) y α-glucosidasa (85.1%). Conclusiones: El MeOH-Ex de las hojas de B. simaruba representa una fuente de metabolitos secundarios con potencial actividad antidiabética. Los compuestos fenólicos tentativamente identificados podrían desempeñar un papel importante en la prevención de trastornos por hiperglucemia posprandial al inhibir las enzimas α-amilasa y α-glucosidasa. Destaca la presencia de ácido clorogénico como uno de los principales compuestos bioactivos potenciales en las hojas de B. simaruba

The Impact Of Rituximab Infusion Protocol On The Long-term Outcome In Anti-musk Myasthenia Gravis

Objective: To evaluate whether the clinical benefit and relapse rates in anti-muscle-specific kinase (MuSK) myasthenia gravis (MG) differ depending on the protocol of rituximab followed. Methods: This retrospective multicentre study in patients with MuSK MG compared three rituximab protocols in terms of clinical status, relapse, changes in treatment, and adverse side effects. The primary effectiveness endpoint was clinical relapse requiring a further infusion of rituximab. Survival curves were estimated using Kaplan-Meier methods and survival analyses were undertaken using Cox proportional-hazards models. Results: Twenty-five patients were included: 11 treated with protocol 4 + 2 (375 mg/m(2)/4 weeks, then monthly for 2 months), five treated with protocol 1 + 1 (two 1 g doses 2 weeks apart), and nine treated with protocol 4 (375 mg/m(2)/4 weeks). Mean follow-up was 5.0 years (SD 3.3). Relapse occurred in 18.2%, 80%, and 33.3%, and mean time to relapse was 3.5 (SD 1.5), 1.1 (SD 0.4), and 2.5 (SD 1.4) years, respectively. Based on Kaplan-Meier estimates, patients treated with protocol 4 + 2 had fewer and later relapses than patients treated with the other two protocols (log-rank test P = 0.0001). Patients treated with protocol 1 + 1 had a higher risk of relapse than patients treated with protocol 4 + 2 (HR 112.8, 95% CI, 5.7-2250.4, P = 0.002). Patients treated with protocol 4 showed a trend to a higher risk of relapse than those treated with protocol 4 + 2 (HR 9.2, 95% CI 0.9-91.8, P = 0.059). InterpretationThis study provides class IV evidence that the 4 + 2 rituximab protocol has a lower clinical relapse rate and produces a more durable response than the 1 + 1 and 4 protocols in patients with MuSK MG

Distribution and genotype-phenotype correlation of GDAP1 mutations in Spain

Mutations in the GDAP1 gene can cause Charcot-Marie-Tooth disease. These mutations are quite rare in most Western countries but not so in certain regions of Spain or other Mediterranean countries. This cross-sectional retrospective multicenter study analyzed the clinical and genetic characteristics of patients with GDAP1 mutations across Spain. 99 patients were identified, which were distributed across most of Spain, but especially in the Northwest and Mediterranean regions. The most common genotypes were p.R120W (in 81% of patients with autosomal dominant inheritance) and p.Q163X (in 73% of autosomal recessive patients). Patients with recessively inherited mutations had a more severe phenotype, and certain clinical features, like dysphonia or respiratory dysfunction, were exclusively detected in this group. Dominantly inherited mutations had prominent clinical variability regarding severity, including 29% of patients who were asymptomatic. There were minor clinical differences between patients harboring specific mutations but not when grouped according to localization or type of mutation. This is the largest clinical series to date of patients with GDAP1 mutations, and it contributes to define the genetic distribution and genotype-phenotype correlation in this rare form of CMT

Compromising between European and US allergen immunotherapy schools: Discussions from GUIMIT, the Mexican immunotherapy guidelines

Background: Allergen immunotherapy (AIT) has a longstanding history and still remains the only disease-changing treatment for allergic rhinitis and asthma. Over the years 2 different schools have developed their strategies: the United States (US) and the European. Allergen extracts available in these regions are adapted to local practice. In other parts of the world, extracts from both regions and local ones are commercialized, as in Mexico. Here, local experts developed a national AIT guideline (GUIMIT 2019) searching for compromises between both schools. Methods: Using ADAPTE methodology for transculturizing guidelines and AGREE-II for evaluating guideline quality, GUIMIT selected 3 high-quality Main Reference Guidelines (MRGs): the European Academy of Allergy, Asthma and Immunology (EAACI) guideines, the S2k guideline of various German-speaking medical societies (2014), and the US Practice Parameters on Allergen Immunotherapy 2011. We formulated clinical questions and based responses on the fused evidence available in the MRGs, combined with local possibilities, patient's preference, and costs. We came across several issues on which the MRGs disagreed. These are presented here along with arguments of GUIMIT members to resolve them. GUIMIT (for a complete English version, see Supplementary data) concluded the following: Results: Related to the diagnosis of IgE-mediated respiratory allergy, apart from skin prick testing complementary tests (challenges, in vitro testing and molecular such as species-specific allergens) might be useful in selected cases to inform AIT composition. AIT is indicated in allergic rhinitis and suggested in allergic asthma (once controlled) and IgE-mediated atopic dermatitis. Concerning the correct subcutaneous AIT dose for compounding vials according to the US school: dosing tables and formula are given; up to 4 non-related allergens can be mixed, refraining from mixing high with low protease extracts. When using European extracts: the manufacturer's indications should be followed; in multi-allergic patients 2 simultaneous injections can be given (100% consensus); mixing is discouraged. In Mexico only allergoid tablets are available; based on doses used in all sublingual immunotherapy (SLIT) publications referenced in MRGs, GUIMIT suggests a probable effective dose related to subcutaneous immunotherapy (SCIT) might be: 50–200% of the monthly SCIT dose given daily, maximum mixing 4 allergens. Also, a table with practical suggestions on non-evidence-existing issues, developed with a simplified Delphi method, is added. Finally, dissemination and implementation of guidelines is briefly discussed, explaining how we used online tools for this in Mexico. Conclusions: Countries where European and American AIT extracts are available should adjust AIT according to which school is followed

SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio