Mobile genetic elements related to the diffusion of plasmid-mediated AmpC β-lactamases or carbapenemases from enterobacteriaceae: Findings from a multicenter study in Spain

We examined the genetic context of 74 acquired ampC genes and 17 carbapenemase genes from 85 of 640 Enterobacteriaceae isolates collected in 2009. Using S1 pulsed-field gel electrophoresis and Southern hybridization, 37 of 74 blaAmpC genes were located on large plasmids of different sizes belonging to six incompatibility groups. We used sequencing and PCR mapping to investigate the regions flanking the acquired ampC genes. The blaCMY-2-like genes were associated with ISEcp1; the surrounding blaDHA genes were similar to Klebsiella pneumoniae plasmid pTN60013 associated with IS26 and the psp and sap operons; and the blaACC-1 genes were associated with IS26 elements inserted into ISEcp1. All of the carbapenemase genes (blaVIM-1, blaIMP-22, and blaIMP-28) were located in class 1 integrons. Therefore, although plasmids are the main cause of the rapid dissemination of ampC genes among Enterobacteriaceae, we need to be aware that other mobile genetic elements, such as insertion sequences, transposons, or integrons, can be involved in the mobilization of these genes of chromosomal origin. Additionally, three new integrons (In846 to In848) are described in this study.Ministerio de Educación BFU2008-00995/BMCMinisterio de Sanidad, Servicios Sociales e Igualdad y Instituto de Salud Carlos III y FEDER REIPI/RD06/0008/0013 FIS 09/ 0125Ministerio de Sanidad, Servicios Sociales e Igualdad y Instituto de Salud Carlos III y Spanish Network for Research in Infectious Diseases REIPI/RD06/0008/0013 FIS 09/ 012

Evaluación de micro innovaciones para la mejora continua de la asignatura Tecnología Medioambiental

[ES] Esta comunicación reflexiona sobre la introducción de micro innovaciones en la asignatura Tecnología Medioambiental del Grado en Ingeniería Mecánica en la Escuela Técnica Superior de Ingeniería del Diseño de la Universitat Politècnica de València. La estrategia innovadora responde a las tendencias del empleo de las nuevas tecnologías, la creación comunicativa de contenidos y la interdependencia en el aprendizaje. Se explica la realización de documentación multimedia por parte de los estudiantes como metodología docente, incluyendo actividades de evaluación por pares. Consideramos que es adecuada para el desarrollo de la competencia transversal “Conocimiento del mundo contemporáneo”, mediante la búsqueda de nuevos conocimientos y la exposición y crítica de los trabajos realizados. Se detalla la investigación realizada para poder mejorar y escalar dichas micro innovaciones.[EN] This paper presents some micro innovations in Environmental Technology, a subject of the Mechanical Engineering Degree of the Universitat Politècnica de València. The innovative strategy responds to the trends of the use of ICT, the technical communication skills and the interdependent learning.Multimedia content creation from students as a part of the teaching methodology, and peer evaluation are presented. Adequacy to development of the transversal competence “Contemporary world understanding” is considered, through desk research, critical thinking and exhibition of the outcomes.In order to improve and scale the micro innovations, a research was conducted. Details about the research methods and results are provided.Luján Facundo, MJ.; Rodríguez López, AD.; Ferrer Polonio, E.; Laguarda Miró, N.; Pascual Garrido, J.; Fuentes-Durá, P. (2021). Evaluación de micro innovaciones para la mejora continua de la asignatura Tecnología Medioambiental. En IN-RED 2020: VI Congreso de Innovación Educativa y Docencia en Red. Editorial Universitat Politècnica de València. 402-411. https://doi.org/10.4995/INRED2020.2020.11969OCS40241

Prognostic factors of Infective Endocarditis in Patients on Hemodialysis: A Case Series from a National Multicenter Registry.

Background: Infective endocarditis (IE) is a severe complication associated with high mortality. Objectives: To examine the clinical characteristics of IE in hemodialysis (HD) patients and to determine prognostic factors related to HD. Methods: From January 2008 to April 2015, 2,488 consecutive patients with definite IE were included. Clinical characteristics of IE patients on HD were compared with those of IE patients who were not on HD. Results: A total of 126 patients (63% male, median age: 66 years; IQR: 54-74 years) with IE (5.1%) were on HD. Fifty-two patients died during hospitalization (41%) and 17 additional patients (14%) died during the first year. The rate of patients who underwent surgery during hospitalization was lower in HD patients (38 patients, 30%) than in non-HD patients (1,177 patients, 50%; p 70 years (OR: 4.1, 95% CI: 1.7-10), heart failure (OR: 3.3, 95% CI: 1.4-7-6), central nervous system (CNS) vascular events (OR: 6.7, 95% CI: 2.1-22) and septic shock (OR: 4.1, 95% CI: 1.4-12.1) were independently associated with fatal outcome in HD patients. Of the 38 patients who underwent surgery, 15 (39.5%) died during hospitalization. Conclusions. HD patients with IE present a high mortality. Advanced age and complications, such as heart failure, CNS stroke or septic shock, are associated with mortality.pre-print714 K

Simulación de sistemas energéticos como metodología para el desarrollo competencial en la asignatura Ampliación de Energía

[EN] The implementation of the New Masters for the convergence to the EHEA has led to the appearance of new advanced subjects of marked technical and professional character in the new master's degrees. The main objective of this project has been the development and experimentation of free software, under Matlab environment, for the preparation of a portfolio for the development of the competences of the Master's degree in Industrial Engineering, as well as the transversal competences of the subject of Advanced Energy and Thermal Machines. The development and use of free mathematical software for the resolution of professional problems of design and analysis of real industrial energy systems will facilitate the student's work by its easy availability, but needs to be oriented on the resources and time available, as well as on the use and capabilities of the developed programs.[ES] La implantación de los Nuevos Másteres para la convergencia al EEES ha llevado aparejada la aparición de nuevas asignaturas avanzadas de marcado carácter técnico y profesional en los nuevos másteres habilitantes. El objetivo principal del presente proyecto ha sido el desarrollo y experimentación de software libre, bajo entorno Matlab, para la elaboración de un portafolio para el desarrollo de las competencias propias del título de Máster en Ingeniería Industrial, así como de las competencias transversales de la asignatura de Ampliación de Energía y Motores Térmicos. El desarrollo y empleo de software matemático libre para la resolución de problemas profesionales de diseño y análisis de sistemas energéticos industriales reales facilitará la labor discente del alumno por su fácil disponibilidad, pero necesita ser orientado sobre los recursos y tiempo disponibles, así como sobre el uso y capacidades de los programas desarrollados.Los autores de este trabajo quieren expresar su gratitud al Instituto de Ciencias de la Educación y a la Escuela Técnica Superior de Ingenieros Industriales de la Universitat Politècnica de València, por su apoyo y financiación para la realización de este PIME concedido en el curso 2016-2017 (proyecto B25). Este proyecto forma parte de los trabajos llevados a cabo por los miembros del EICE SEERI del Departamento de Ingniería Química y Nuclear.Miró Herrero, R.; Barrachina Celda, TM.; Juste Vidal, BJ.; Sanchís Arnal, R.; Palomo Anaya, MJ.; Escrivá Castells, FA.; Guardiola, C.... (2018). Simulación de sistemas energéticos como metodología para el desarrollo competencial en la asignatura Ampliación de Energía. En IN-RED 2018. IV Congreso Nacional de Innovación Educativa y Docencia en Red. Editorial Universitat Politècnica de València. 1519-1528. https://doi.org/10.4995/INRED2018.2018.8758OCS1519152

Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention

AIM: To evaluate the effect of the type of surgical indication on mortality in infective endocarditis (IE) patients who are rejected for surgery. METHODS AND RESULTS: From January 2008 to December 2016, 2714 patients with definite left-sided IE were attended in the participating hospitals. One thousand six hundred and fifty-three patients (60.9%) presented surgical indications. Five hundred and thirty-eight patients (32.5%) presented surgical indications but received medical treatment alone. The indications for surgery in these patients were uncontrolled infection (366 patients, 68%), heart failure (168 patients, 31.3%) and prevention of embolism (148 patients, 27.6%). One hundred and thirty patients (24.2%) presented more than one indication. The mortality during hospital admission was 60% (323 patients). The in-hospital mortality of patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 75.6%, 61.4% and 54.7%, respectively (p?<?0.001). Surgical indications due to heart failure (OR: 3.24; CI 95%: 1.99-5.9) or uncontrolled infection (OR: 1.83; CI 95%: 1.04-3.18) were independently associated with a fatal outcome during hospital admission. Mortality during the first year was 75.4%. The mortality during the first year in patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 85.9%, 76.7% and 72.7%, respectively (p?=?0.016). Surgical indication due to heart failure (OR: 3.03; CI 95%: 1.53-5.98) were independently associated with fatal outcome during the first year. CONCLUSIONS: The type of surgical indication is associated with mortality in IE patients who are rejected for surgical intervention

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Co-creación + Biomecánica: claves de éxito para el diseño de ortesis de rodilla

[ES] El sector de la ortopedia es cada vez más exigente y competitivo. Los pacientes que sufren artrosis requieren soluciones que mejoren su autonomía personal y atenúen los efectos de la enfermedad, sin perder autonomía y calidad de vida. EMO e IBV han diseñado y desarrollado una nueva generación de ortesis de rodilla que se adapta a la antropometría y biomédica de los usuarios, teniendo en cuenta el contexto de uso, la usabilidad y las necesidades y preferencias de los usuarios y profesionales. Para lograr una solución tan avanzada ha sido necesaria la participación de u equipo multidisciplinar y la realización de diversos estudios de laboratorio que han ido perfilando el proceso de diseño y desarrollo centrado en los usuarios.Al IVACE y Fondos FEDER por el apoyo del proyecto dentro del programa de Ayudas para proyectos de I+D para PYMEs del IVACE (código de proyecto IMIDTA/2018/95).Puigcerver Palau, SA.; Baydal Bertomeu, JM.; Piqueras Fiszman, P.; Soriano Garcia, C.; Uriel Moltó, J.; Requena Miró, J.; Iordanov López, D.... (2019). Co-creación + Biomecánica: claves de éxito para el diseño de ortesis de rodilla. Revista de Biomecánica (Online). (66):1-9. http://hdl.handle.net/10251/160582S196

Clinical presentation, microbiology, and prognostic factors of prosthetic valve endocarditis. Lessons learned from a large prospective registry.

BackgroundProsthetic valve endocarditis (PVE) is a serious infection associated with high mortality that often requires surgical treatment.MethodsStudy on clinical characteristics and prognosis of a large contemporary prospective cohort of prosthetic valve endocarditis (PVE) that included patients diagnosed between January 2008 and December 2020. Univariate and multivariate analysis of factors associated with in-hospital mortality was performed.ResultsThe study included 1354 cases of PVE. The median age was 71 years with an interquartile range of 62-77 years and 66.9% of the cases were male. Patients diagnosed during the first year after valve implantation (early onset) were characterized by a higher proportion of cases due to coagulase-negative staphylococci and Candida and more perivalvular complications than patients detected after the first year (late onset). In-hospital mortality of PVE in this series was 32.6%; specifically, it was 35.4% in the period 2008-2013 and 29.9% in 2014-2020 (p = 0.031). Variables associated with in-hospital mortality were: Age-adjusted Charlson comorbidity index (OR: 1.15, 95% CI: 1.08-1.23), intracardiac abscess (OR:1.78, 95% CI:1.30-2.44), acute heart failure related to PVE (OR: 3. 11, 95% CI: 2.31-4.19), acute renal failure (OR: 3.11, 95% CI:1.14-2.09), septic shock (OR: 5.56, 95% CI:3.55-8.71), persistent bacteremia (OR: 1.85, 95% CI: 1.21-2.83) and surgery indicated but not performed (OR: 2.08, 95% CI: 1.49-2.89). In-hospital mortality in patients with surgical indication according to guidelines was 31.3% in operated patients and 51.3% in non-operated patients (pConclusionsNot performing cardiac surgery in patients with PVE and surgical indication, according to guidelines, has a significant negative effect on in-hospital mortality. Strategies to better discriminate patients who can benefit most from surgery would be desirable