Innovación en las enseñanzas universitarias: experiencias presentadas en las III Jornadas de Innovación Educativa de la ULL

En este libro se recoge un conjunto de experiencias de innovación educativa desarrolladas en la ULL en el curso 2011-12. Se abordan distintos ámbitos y ramas del conocimiento, y ocupan temáticas variadas que han sido desarrolladas con rigor, y con un claro potencial para su extrapolación a efectos de la mejora educativa en el ámbito universitario. Esta publicación constituye una primera edición de una serie que irá recogiendo las experiencias de innovación educativa de la ULL. Este es un paso relevante para su impulso en nuestra institución, como lo es el de su vinculación con la investigación educativa, para potenciar su publicación en las revistas científicas en este ámbito cada vez más pujante y relevante para las universidades. Sobre todo representan el deseo y el compromiso del profesorado de la ULL para la mejora del proceso educativo mediante la investigación, la evaluación y la reflexión compartida de nuestras prácticas y planteamientos docentes

Catéteres venosos centrales permanentes tunelizados para hemodiálisis: estudio de recirculación y dosis de diálisis con líneas normales e invertidas

Introducción: Los Catéteres Venosos Centrales Permanentes Tunelizados para hemodiálisis presentan con frecuencia una complicación denominada efecto ventana o ventosa, en el que la rama arterial se colapsa en las maniobras de aspiración sin ofrecer resistencia al impeler, determinando la inversión de líneas para poder realizar el tratamiento. El estudio se centra en la relación entre la posición anatómica de las puntas del catéter mediante radiografía de tórax y la recirculación medida con Dilución Ultrasónica, el Porcentaje de Reducción de Urea y el Kt/V, determinados tanto con líneas en posición normal e invertida y a flujos de bomba de 250 y 300 ml/min. Material y método: Estudio Cuasiexperimental Intrasujeto de 18 meses de duración a n=28 catéteres implantados en 25 pacientes en Hemodiálisis. Resultados: • Recirculación: • Líneas normales a 250 y 300 ml/min: 0,85 ± 2,41% y 1,23 ± 3,14%. • Líneas invertidas a 250 y 300 ml/min; 22,41 ± 12,12% y 24,93 ± 12,09%. • Porcentaje de Reducción de Urea: • Líneas normales a 250 y 300 ml/min; 66,49 ± 8,62% y 70,55 ± 5,30%. • Líneas invertidas a 250 y 300 ml/min; 61,05 ± 8,34% y 62,34 ± 8,68%. • Kt/V: • Líneas normales a 250 y 300 ml/min: 1,31 ± 0,30 y 1,46 ± 0,23%. • Líneas invertidas a 250 y 300 ml/min: 1,10 ± 0,21% y 1,19 ± 0,30%. Discusión: Los Porcentajes de Reducción de Urea y Kt/V con líneas invertidas a ambos flujos estudiados, manifiestan dosis de diálisis adecuadas asumiendo recirculaciones entorno al 20%

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field