El reconocimiento de los aprendizajes adquiridos por la experiencia previa: un nuevo reto para el sistema universitario

El propósito del Reconocimiento de los Aprendizajes derivados de la Experiencia Previa (RAEP) es hacer visible el abanico de competencias que posee una persona, independientemente del contexto donde la adquisición de éstas tuvo lugar. En este artículo se analiza el papel del reconocimiento del aprendizaje experiencial dentro de una visión amplia de la educación y se presentan sus elementos clave. Se comenta el rol del RAEP en la educación superior, señalando asimismo las oportunidades y desafíos que este tipo de procesos impone a los protagonistas de la enseñanza universitaria

Intravitreal bevacizumab (Avastin) for choroidal metastasis secondary to breast carcinoma: short-term follow-up

Uveal metastases are the most common intraocular malignancy. The most common primary sites of cancer are from the breast (47%) and lung (21%).1 The treatment for choroidal metastasis depends on many factors including location, multiplicity, and activity of each tumour.1 Bevacizumab (Avastins) is a full-length humanized murine monoclonal antibody against the VEGF molecule, and inhibits angiogenesis and tumour growth.2 In this report, we describe the effect of a single intravitreal injection of bevacizumab (4 mg) in a patient with choroidal metastasis secondary to breast cancerMedicin

Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study

Background: The medium-term and long-term impact of COVID-19 in patients with cancer is not yet known. In this study, we aimed to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. We also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection. Methods: OnCovid is an active European registry study enrolling consecutive patients aged 18 years or older with a history of solid or haematological malignancy and who had a diagnosis of RT-PCR confirmed SARS-CoV-2 infection. For this retrospective study, patients were enrolled from 35 institutions across Belgium, France, Germany, Italy, Spain, and the UK. Patients who were diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, and entered into the registry at the point of data lock (March 1, 2021), were eligible for analysis. The present analysis was focused on COVID-19 survivors who underwent clinical reassessment at each participating institution. We documented prevalence of COVID-19 sequelae and described factors associated with their development and their association with post-COVID-19 survival, which was defined as the interval from post-COVID-19 reassessment to the patients’ death or last follow-up. We also evaluated resumption of systemic anti-cancer therapy in patients treated within 4 weeks of COVID-19 diagnosis. The OnCovid study is registered in ClinicalTrials.gov, NCT04393974. Findings: 2795 patients diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, were entered into the study by the time of the data lock on March 1, 2021. After the exclusion of ineligible patients, the final study population consisted of 2634 patients. 1557 COVID-19 survivors underwent a formal clinical reassessment after a median of 22·1 months (IQR 8·4–57·8) from cancer diagnosis and 44 days (28–329) from COVID-19 diagnosis. 234 (15·0%) patients reported COVID-19 sequelae, including respiratory symptoms (116 [49·6%]) and residual fatigue (96 [41·0%]). Sequelae were more common in men (vs women; p=0·041), patients aged 65 years or older (vs other age groups; p=0·048), patients with two or more comorbidities (vs one or none; p=0·0006), and patients with a history of smoking (vs no smoking history; p=0·0004). Sequelae were associated with hospitalisation for COVID-19 (p<0·0001), complicated COVID-19 (p<0·0001), and COVID-19 therapy (p=0·0002). With a median post-COVID-19 follow-up of 128 days (95% CI 113–148), COVID-19 sequelae were associated with an increased risk of death (hazard ratio [HR] 1·80 [95% CI 1·18–2·75]) after adjusting for time to post-COVID-19 reassessment, sex, age, comorbidity burden, tumour characteristics, anticancer therapy, and COVID-19 severity. Among 466 patients on systemic anti-cancer therapy, 70 (15·0%) permanently discontinued therapy, and 178 (38·2%) resumed treatment with a dose or regimen adjustment. Permanent treatment discontinuations were independently associated with an increased risk of death (HR 3·53 [95% CI 1·45–8·59]), but dose or regimen adjustments were not (0·84 [0·35–2·02]). Interpretation: Sequelae post-COVID-19 affect up to 15% of patients with cancer and adversely affect survival and oncological outcomes after recovery. Adjustments to systemic anti-cancer therapy can be safely pursued in treatment-eligible patients. Funding: National Institute for Health Research Imperial Biomedical Research Centre and the Cancer Treatment and Research Trust

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Performance of different C18 columns in reversed-phase liquid chromatography with hydro-organic and micellar-organic mobile phases

Column selection in reversed-phase liquid chromatography (RPLC) can become a challenge if the target compounds interact with the silica-based packing. One of such interactions is the attraction of cationic solutes to the free silanols in silica-based columns, which is a slow sorption–desorption interaction process that gives rise to tailed and broad peaks. The effect of silanols is minimised by the addition of a competing agent in the mobile phase, such as the anionic surfactant sodium dodecyl sulphate (SDS). In micellar-organic RPLC, the adsorption of an approximately fixed amount of SDS monomers gives rise to a stable modified stationary phase, with properties remarkably different from those of the underlying bonded phase. The chromatographic behaviour (in terms of selectivity, analysis time and peak shape) of eight C18 columns in the analysis of weakly acidic phenols and basic β-blockers was examined with hydro-organic and micellar-organic mobile phases. The behaviour of the columns differed significantly when the cationic basic drugs were eluted with hydro-organic mobile phases. With micellar-organic mobile phases, the adsorption of surfactant, instead of making the columns similar, gave rise to a greater diversity of behaviours (especially in terms of selectivity and analysis time), for both groups of phenols and β-blockers, which should be explained by the residual effect of the underlying bonded stationary phase and the different amount of surfactant covering the packing. Therefore, the implementation of a micellar-organic procedure in RPLC will depend significantly on the selected type of C18 column

UAVEMI project: numerical and experimental EM immunity assessment of UAV for HIRF and lightning indirect effects

The UAVEMI project, funded by the Spanish Ministry of Economy and Competitiveness, gathers a consortium formed by several research and development institutions and one industrial partner. The main goal is to develop innovative experimental and numerical approaches for the assessment of the electromagnetic compatibility of unmanned air vehicles, under high intensity radiated fields, lightning indirect effects and non-nuclear electromagnetic pulses. This contribution describes the capabilities currently being developed under the projectPeer ReviewedPostprint (published version

UAVEMI project: numerical and experimental EM immunity assessment of UAV for HIRF and lightning indirect effects

The UAVEMI project, funded by the Spanish Ministry of Economy and Competitiveness, gathers a consortium formed by several research and development institutions and one industrial partner. The main goal is to develop innovative experimental and numerical approaches for the assessment of the electromagnetic compatibility of unmanned air vehicles, under high intensity radiated fields, lightning indirect effects and non-nuclear electromagnetic pulses. This contribution describes the capabilities currently being developed under the projectPeer Reviewe

Imaging the crustal structure of the Central Iberian Zone (Variscan Belt): The ALCUDIA deep seismic reflection transect

ALCUDIA is a 230 km long, vertical incidence deep seismic reflection transect acquired in spring 2007 across the southern Central Iberian Zone (part of the pre-Mesozoic Gondwana paleocontinent) of the Variscan Orogen of Spain. The carefully designed acquisition parameters resulted in a 20 s TWTT deep, 60–90 fold, high-resolution seismic reflection transect. The processed image shows a weakly reflective upper crust (the scarce reflectivity matching structures identified at surface), a thick, highly reflective and laminated lower crust, and a flat Moho located at 10 s TWTT (30 km depth). The transect can be divided into three segments with different structural styles in the lower crust. In the central segment, the lower crust is imaged by regular, horizontal and parallel reflectors, whereas in the northern and southern segments it displays oblique reflectors interpreted as an important thrust (north) and tectonic wedging involving the mantle (south). The ALCUDIA seismic image shows that in an intracontinental orogenic crust, far from the suture zones, the upper and lower crust may react differently to shortening in different sectors, which is taken as evidence for decoupling. The interpreted structures, as deduced from surface geology and the seismic image, show that deformation was distributed homogeneously in the upper crust, whereas it was concentrated in wedge/thrust structures at specific sectors in the lower crust. The seismic image also shows the location of late Variscan faults in spatial association with the lower crustal thickened areas