Perceptions about the Self-Learning Methodology in Simulated Environments in Nursing Students: A Mixed Study

The self-learning methodology in simulated environments (MAES©) is an active method of education. The aim of this study was to analyze the perceptions and opinions of undergraduate and graduate nursing students about the self-learning methodology in simulated environments. A mixed, cross-sectional, descriptive study based on a survey tool made ad hoc (quantitative approach) and an open questionnaire (qualitative approach) was carried out. A sample of 149 undergraduate and 25 postgraduate nursing students were tested. The score was high for all the variables of the questionnaire analyzed: for perception of simulation performance, M = 73.5 (SD = 14.5), for motivation, M = 23.9 (SD = 5.9), for the opinion about facilitators, M = 25.9 (SD = 4.5), and for the promotion of team work, M = 16.9 (SD = 3.4). Five dimensions were identified and evaluated in the qualitative research. The students were pleased with MAES© and had a positive perception, since they considered that MAES© increased their learning

1,4-Cyclohexanedicarboxylato-bridged cobalt coordination polymers: Synthesis, crystal structures and magnetic properties

1,4-Cyclohexanedicarboxylato-bridged cobalt coordination polymers: Synthesis, crystal structures and magnetic propertiesThree coordination polymers have been synthesized, using self-assembly solution reactions at ambient conditions, combining Co(II) ion with 1,4-ciclohexanedicarboxylic acid, in the presence of 1,10-phenantrolione and two different 2,20-bipyridines, as co-ligands: [Co(H2O)(cdc)(phen)]n (1); {[Co(H2O)(cdc)(4dmb)] 2H2O}n (2); {[Co(H2O)(cdc)(5dmb)] 3H2O}n (3), where cdc = e,a-cis-1,4-ciclohexanedicarboxylato, phen = 1,10-phenantroline, 4dmb = 4,40-dimethyl-2,20-bipyridine, and 5dmb = 5,50-dimethyl-2,20-bipyridine. Crystallographic studies show that these compounds have one-dimensional (1D) structures; Co(II) in 1–3 is six-coordinated with a distorted-octahedral coordination sphere. Complexes 2 and 3 exhibit a novel bridging motif of the cdc ligand in its equatorial, axial cis configuration. In addition, the solid-state self-assembly of the polymeric structure of 1 gives rise to a 2D supramolecular framework, mainly through hydrogen bonding. In contrast, complex 2 forms an infinite 1D supramolecular array, made of double Co ion rows bridged by hydrogen bonding interactions. Complex 3 generates an intricate 2D supramolecular framework also throughout hydrogen bonding. The thermal stabilities of the three coordination polymers were investigated. Magnetic properties measurements reveal that complexes 1–3 exhibit weak antiferromagnetic ordering with h(C-W) = 9.6, 5.8 and 7.5 K, and E2 = 0.51, 0.16 and 0.28 cm 1, accordingly to Curie-Weiss model and Rueff phenomenological approach, respectively

Utilización de dibujos, imágenes y otros elementos multimedia en el diseño de recursos para la docencia virtual

Se presentan una serie de recursos hipermedia, que el grupo de autores han desarrollado con el ánimo de facilitar el aprendizaje de los alumnos en disciplinas de alto contenido descriptivo. En este caso concreto se refieren a la anatomía microscópica animal y vegetal, aunque las aplicaciones informáticas y procedimientos empleados son aplicables también a otras disciplinas, siempre con dicho carácter descriptivo en común. Fundamentalmente se trata de módulos interactivos de autoaprendizaje en formato SCORM, que incorporan como principal elemento dibujos descriptivos sobre las estructuras histológicas estudiadas. Tales dibujos se presentan al usuario como archivos tipo flash, con visualización interactiva y secuencial, para facilitar su comprensión. A la vez, incorporan enlaces con otra aplicación, diseñada previamente por los autores, bajo el aspecto de atlas histológico, en el que se recogen ejemplos de la realidad en forma de microfotografías, algunas de ellas navegables (microscopía virtual). Incluyen igualmente pruebas de autoevaluación y la posibilidad, dado su formato compatible, de que el profesor pueda realizar un completo seguimiento de su utilización a través de diferentes Plataformas de Docencia Virtual (LMSs). Por otro lado se han desarrollado otros recursos hipermedia en formato AVI de contenidos relacionados con el manejo de dispositivos y técnicas de uso habitual en histología. Incluyen, además de las grabaciones en video, imágenes fijas, texto, títulos de crédito y comentarios hablados ilustrando los contenidos expuestos. El acceso a este material se hace a través de una página web índice, con hipervínculos a cada archivo. Todos los recursos presentados se encuentran actualmente disponibles a través del servidor y la LMS de la Universidad de Jaén, pudiéndose acceder a los mismos desde la URL: http://virtual.ujaen.es/atlas/.This work is addressed to introduce a number of hypermedia resources aimed to facilitate the learning of students in descriptive disciplines. We have focused on animal and vegetal microscopic anatomy, although the applications and procedures described can be also applicable to other descriptive disciplines. In this way, self-study interactive modules in SCORM format were designed, incorporating descriptive drawings of the histological structures. These drawings are presented as flash-type files to the users, which can observe them in an interactive and sequential way to facilitate understanding. At the same time, they incorporate links to an interactive histological atlas, previously designed by the authors, in which are collected real photomicrographs, some of them available as “virtual microscopy” (a section that allows examining images as real observations using the microscope). The drawings also include self-evaluation tests, as well as the possibility that the teacher can conduct an exhaustive monitoring of the use of this teaching tool through different Learning Management Systems (LMSs). On the other hand, other hypermedia resources in AVI format have been developed. Such tools are related to the management of devices and techniques commonly used in Histology. They also include video recordings, images, text, credit, and spoken comments illustrating the contents. The access to this material can be achieved through an index web page with hyperlinks to each file. These tools are currently available through the server and LMS of the University of Jaén (Spain) in http://virtual.ujaen.es/atlas/

Pumpkin seeds (Cucurbita moschata - Jacarezinho cultivar): characterization of the oil extracted by solvent and supercritical fluid and study of anti-parasitary activity / Sementes de abóbora (Cucurbita moschata - cultivar Jacarezinho): caracterização do óleo extraído por solvente e fluido supercrítico e estudo da atividade antiparasitária

The presence of many biologically active components makes pumpkins extremely attractive to the phytochemical manufacturing industry. Studies have demonstrated that the oil extracted from the seeds has different biological activities. This study aimed to determine the fatty acid composition and total tocopherol content of the pumpkin seed oil (Cucurbita moschata – Jacarezinho cultivar) extracted by supercritical carbon dioxide (Sc-CO2) and hexane/isopropanol. The fatty acids composition and content of total tocopherols were determined by GC, GC/FID, HPLC, respectively. We also evaluated in vitro schistosomicidal activities of the crude oil, which have been described with anti-parasitic activities. Sc-CO2 extracted pumpkin seed oil, with a maximum yield of 24.3 ± 0.4%, much higher than hexane/isopropanol extraction (8.3 ± 2.7%). Was not observe differences between the non-polar compounds present in the oil extracted by both methods. In the seed oil, unsaturated acids are dominant (oleic and linoleic). The results indicate that the oil has an excellent quality, with high contents of unsaturated fatty acids (73% of total fatty acids) and total tocopherols (14 mg100g-1 of oil). Although popularly reported as anti-parasitic activities caused no mortality, tegumental alterations or significant decrease in motor activity in all adult parasites. Sc-CO2 was able to extract pumpkin seed oil with a much higher yield than extraction with hexane/isopropanol and no differences were observe between the non-polar compounds present in the oil extracted by both methods. The oil is popularly used as an antiparasitic agent but in this study did not show antiparasitary actividies

Sex Differences and Predictors of In-Hospital Mortality among Patients with COVID-19: Results from the ANCOHVID Multicentre Study

Spain is one of the countries most affected by the COVID-19 pandemic. Although risk factors for severe disease are published, sex differences have been widely neglected. In this multicentre study, we aimed to identify predictors of in-hospital mortality in men and women hospitalised with COVID-19. An observational longitudinal study was conducted in the cohort of patients admitted to four hospitals in Andalusia, Spain, from 1 March 2020 to 15 April 2020. Sociodemographic and clinical data were collected from hospital records. The Kaplan–Meier method was used to estimate 30-day survival and multiple Cox regression models were applied. All analyses were stratified by sex. A total of 968 patients were included (54.8% men, median age 67.0 years). In-hospital mortality reached 19.1% in men and 16.0% in women. Factors independently associated with an increased hazard of death were advanced age, higher CURB-65 score and not receiving azithromycin treatment, in both sexes; active cancer and autoimmune disease, in men; cardiovascular disease and chronic lung disease, in women. Disease outcomes and predictors of death differed between sexes. In-hospital mortality was higher in men, but the long-term effects of COVID-19 merit further research. The sex-differential impact of the pandemic should be addressed in public health policies

Differences in the yield of the implantable loop recorder between secondary and tertiary centers

Background: The implantable loop recorder (ILR) is a useful tool for diagnosis of syncope or palpitations. Its easy use and safety have extended its use to secondary hospitals (those without an Electrophysiology Lab). The aim of the study was to compare results between secondary and tertiary hospitals. Methods: National prospective and multicenter registry of patients with an ILR inserted for clinical reasons. Data were collected in an online database. The follow-up ended when the first diagnostic clinical event occurred, or 1 year after implantation. Data were analyzed according to the center of reference; hospitals with Electrophysiology Lab were considered Tertiary Hospi­tals, while those hospitals without a lab were considered Secondary Hospitals. Results: Seven hundred and forty-three patients (413 [55.6%] men; 65 ± 16 year-old): 655 (88.2%) from Tertiary Centers (TC) and 88 (11.8%) from Secondary Centers (SC). No differences in clinical characteristics between both groups were found. The electrophysi­ologic study and the tilt table test were conducted more frequently in Tertiary Centers. Fol­low-up was conducted for 680 (91.5%) patients: 91% in TC and 94% in SC. There was a higher rate of final diagnosis among SC patients (55.4% vs. 30.8%; p < 0.001). Tertiary Hospital patients showed a trend towards a higher rate of neurally mediated events (20% vs. 4%), while bradyarrhythmias were more frequent in SC (74% vs. 60%; p = 0.055). The rate of deaths and adverse events was similar in both populations. Conclusions: Patients with an ILR in SC and TC have differences in terms of the use of complementary tests, but not in clinical characteristics. There was a higher rate of diagnosis in Secondary Hospital patients.

Evaluation of cervical cancer prevention plan in a remote rural area in Bolivia

Objetivos: Evaluar el plan de prevención del cáncer de cérvix en Roboré como ejemplo de zona rural remota de Bolivia e identificar los principales elementos favorables y desfavorables a la implantación del mismo para formular recomendaciones. Material y métodos: Estudio descriptivo transversal realizado mediante una combinación de métodos: análisis de indicadores relacionados con la cobertura de cribado, oportunidad de tratamiento y cobertura vacunal durante 2018 y 2019; cuestionario sobre conocimientos, actitudes y prácticas dirigido a usuarias del programa de cribado; cuestionario a profesionales implicados en el programa de cribado sobre los puntos fuertes y débiles del programa. Resultados: Las coberturas de cribado fueron bajas (41-46%) en los últimos 2 años, así como la oportunidad de tratamiento (13-16,7%). Las coberturas vacunales fueron altas (92-98%). Tras entrevistar a 82 usuarias se evidenció que un mayor conocimiento sobre el cáncer de cérvix está asociado a un mayor nivel de estudios y a una mayor frecuencia de citologías. Las mujeres tienen una actitud positiva hacia la vacunación a pesar del escaso conocimiento sobre el virus del papiloma humano (VPH) y la vacuna. Los profesionales sanitarios refieren contar con un personal implicado pero escaso, la falta de infraestructuras y la necesidad de incrementar las campañas de concienciación. Conclusiones: Recomendamos aumentar las campañas de concienciación y las estrategias de cribado móviles, disponer de un consultorio propio para la realización de las citologías, incrementar el personal a cargo del programa y mejorar el seguimiento de las mujeres.Objectives: Evaluate the cervical cancer prevention programme in Roboré as an example of a remote rural area of Bolivia, and identify its main strengths and weaknesses in order to formulate recommendations. Materials and methods: Cross-sectional descriptive study using a combination of methods: analysis of indicators related to screening coverage, treatment opportunities, and vaccination coverage during 2018 and 2019; questionnaire to users of the screening programme on their knowledge, attitudes and practices; questionnaire to professionals involved in the screening programme about the strengths and weaknesses of the programme. Results: Screening coverage was low (41-46%) in the last 2 years, as was the opportunity for treatment (13-16.7%). Vaccine coverage was high (92-98%). After interviewing 82 users, it was shown that a greater knowledge of cervical cancer is associated with a higher level of education and a higher frequency of cytologies. Women have a positive attitude towards vaccination despite poor knowledge of human papillomavirus (HPV) and the vaccine. Health professionals report having committed but limited staff, lack of infrastructure and the need to increase awareness campaigns. Conclusions: We recommend increasing the number of awareness campaigns and mobile screening strategies, having separate offices to carry out cytologies, increasing the staff in charge of the programme and improving the follow-up of women

Importance of immunometabolic markers for the classification of patients with major depressive disorder using machine learning

Background: Although there is scientific evidence of the presence of immunometabolic alterations in major depression, not all patients present them. Recent studies point to the association between an inflammatory phenotype and certain clinical symptoms in patients with depression. The objective of our study was to classify major depression disorder patients using supervised learning algorithms or machine learning, based on immunometabolic and oxidative stress biomarkers and lifestyle habits. Methods: Taking into account a series of inflammatory and oxidative stress biomarkers (C-reactive protein (CRP), tumor necrosis factor (TNF), 4-hydroxynonenal (HNE) and glutathione), metabolic risk markers (blood pressure, waist circumference and glucose, triglyceride and cholesterol levels) and lifestyle habits of the participants (physical activity, smoking and alcohol consumption), a study was carried out using machine learning in a sample of 171 participants, 91 patients with depression (71.42% women, mean age = 50.64) and 80 healthy subjects (67.50% women, mean age = 49.12). The algorithm used was the support vector machine, performing cross validation, by which the subdivision of the sample in training (70%) and test (30%) was carried out in order to estimate the precision of the model. The prediction of belonging to the patient group (MDD patients versus control subjects), melancholic type (melancholic versus non-melancholic patients) or resistant depression group (treatment-resistant versus non-treatment-resistant) was based on the importance of each of the immunometabolic and lifestyle variables. Results: With the application of the algorithm, controls versus patients, such as patients with melancholic symptoms versus non-melancholic symptoms, and resistant versus non-resistant symptoms in the test phase were optimally classified. The variables that showed greater importance, according to the results of the area under the ROC curve, for the discrimination between healthy subjects and patients with depression were current alcohol consumption (AUC = 0.62), TNF-α levels (AUC = 0.61), glutathione redox status (AUC = 0.60) and the performance of both moderate (AUC = 0.59) and vigorous physical exercise (AUC = 0.58). On the other hand, the most important variables for classifying melancholic patients in relation to lifestyle habits were past (AUC = 0.65) and current (AUC = 0.60) tobacco habit, as well as walking routinely (AUC = 0.59) and in relation to immunometabolic markers were the levels of CRP (AUC = 0.62) and glucose (AUC = 0.58). In the analysis of the importance of the variables for the classification of treatment-resistant patients versus non-resistant patients, the systolic blood pressure (SBP) variable was shown to be the most relevant (AUC = 0.67). Other immunometabolic variables were also among the most important such as TNF-α (AUC = 0.65) and waist circumference (AUC = 0.64). In this case, sex (AUC = 0.59) was also relevant along with alcohol (AUC = 0.58) and tobacco (AUC = 0.56) consumption. Conclusions: The results obtained in our study show that it is possible to predict the diagnosis of depression and its clinical typology from immunometabolic markers and lifestyle habits, using machine learning techniques. The use of this type of methodology could facilitate the identification of patients at risk of presenting depression and could be very useful for managing clinical heterogeneity.This study was supported in part by grants from the Carlos III Health Institute through the Ministry of Science, Innovation and Universities (PI15/00662, PI15/0039, PI15/00204, PI19/01040), co-funded by the European Regional Development Fund (ERDF) “A way to build Europe”, CIBERSAM, and the Catalan Agency for the Management of University and Research Grants (AGAUR 2017 SGR 1247). We also thank CERCA Programme/Generalitat de Catalunya for institutional support. Work partially supported by Biobank HUB-ICO-IDIBELL, integrated in the Spanish Biobank Network and funded by Instituto de Salud Carlos III (PT17/0015/0024) and by Xarxa Bancs de Tumors de Catalunya sponsored by Pla Director d’Oncologia de Catalunya (XBTC). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. YSC work is supported by the FPI predoctoral grant (FPI 2016/17) from Universidad Autonoma de Madrid. VS received an Intensification of the Research Activity Grant from the Instituto de Salud Carlos III (INT21/00055) during 202

Reliability and validity of an FFQ for South American children and adolescents from the SAYCARE study

Objective:The purpose of this study was to analyse the reliability and validity of a semi-quantitative FFQ to assess food group consumption in South American children and adolescents.Design:The SAYCARE (South American Youth/Child cARdiovascular and Environmental) study is an observational, multicentre, feasibility study performed in a sample of 3-to 18-year-old children and adolescents attending private and public schools from six South American countries. Participants answered the FFQ twice with a two-week interval and three 24-h dietary recalls. Intraclass and Spearman''s correlations, weighted Cohen''s kappa (¿w), percentage of agreement and energy-adjusted Pearson''s correlation coefficients were calculated.Setting:Seven cities in South America (Buenos Aires, Lima, Medelin, Montevideo, Santiago, Sao Paulo and Teresina).Subjects:A sample of 200 children and 244 adolescents for reliability analyses and 252 children and 244 adolescents for validity analyses were included.Results:Depending on the food group, for children and adolescents, reliability analyses resulted in Spearman''s coefficients from 0·47 to 0·73, intraclass correlation coefficients from 0·66 to 0·99, ¿w coefficients from 0·35 to 0·63, and percentage of agreement between 72·75 and 83·52 %. In the same way, validity analyses resulted in Spearman''s coefficients from 0·17 to 0·37, energy-adjusted Pearson''s coefficients from 0·17 to 0·61, ¿w coefficients from 0·09 to 0·24, and percentages of agreement between 45·79 and 67·06 %.Conclusion:The SAYCARE FFQ achieved reasonable reliability and slight-moderate validity for almost all food groups intakes. Accordingly, it can be used for the purpose of ranking the intake of individuals within a population