OTOVIRT: Un flujo de trabajo para el entrenamiento por simulación y el ensayo preoperatorio en cirugía virtual otológica

El desarrollo de intervenciones de cirugía otológica presenta el reto de trabajar con estructuras de muy compleja anatomía y gran variabilidad inter e intra-sujeto. El objetivo de este estudio es introducir un nuevo flujo de trabajo para la simulación virtual de cirugías del oído y la obtención sistemática de variables anatómicas y datos clínicos de los pacientes. El sistema propuesto está basado en el procesado de imágenes, el análisis de elementos finitos de los modelos y la simulación virtual; y ofrece un entorno en el que realizar el análisis pre y post-operatorio. Tras un registro inicial de imágenes de resonancia magnética (RM) y tomografía computerizada (TC), se segmentan una serie de estructuras de interés como el hueso temporal y la cóclea, entre otras, para generar los modelos tridimensionales de la anatomía del paciente. Se ha realizado para ello una armonización de herramientas basadas en software abierto que simplifican y optimizan la capacidad de apoyo al entrenamiento por parte del personal clínico. OTOVIRT ha sido validado en un entorno clínico con imágenes de seis pacientes candidatos a cirugía de implante coclear.Este trabajo ha sido financiado por el proyecto OTOVIRT (PIN-0097-2020): “Cirugía Virtual para el entrenamiento por simulación y el ensayo preoperatorio en cirugía otológica y cirugía endoscópica endonasal”

Guia sobre la infecció pel VIH i la sida a l’atenció primària

Sida; Transmissió; Atenció socialAIDS; Transmission; Social careSida; Transmisión; Atención socialAquesta nova Guia sobre la infecció pel VIH i la sida a l’atenció primària vol ser una eina útil i facilitadora per als professionals del primer nivell assistencial a l’hora d’establir estratègies preventives i actuacions clíniques relacionades amb la infecció pel VIH amb la finalitat de contribuir a la millora de l’atenció a les persones afectades

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Perceptions of teachers and directors about the factors that promote or constrain environmental education in schools of Metropolitan Area of Buenos Aires, Argentina

El trabajo aborda las percepciones de docentes y directores de escuelas acerca delos factores que promueven u obstaculizan una educación ambiental compleja, generadora de conocimientos, con dispositivos participativos y orientados a la equidad en instituciones educativas del Área Metropolitana de Buenos Aires (Argentina). Como resultado se observaron experiencias heterogéneas y voluntad de instalar nuevas prácticas, pero con factores que limitan el cambio: pautas culturales arraigadas; deficiencias en la capacitación docente, en cuanto a las políticas públicas; poca claridad en las definiciones sobre los objetivos de la educación ambiental, su abordaje curricular y los dispositivos pedagógicos. Prevalecen enfoques fragmentados, naturalistas y la ausencia de una visión crítica. A nivel institucional, se discute lapertinencia de implementar prácticas sustentables en el aula. Las propias percepciones también operan como obstáculos. Todo esto dificulta la adopción de nuevas acciones de educación ambiental con el ímpetu necesario para sostenerlas en el tiempo.The paper examines the perceptions of teachers and directors regarding the factors that promote or constrain complex environmental education, which generates knowledge, with participatory devices and oriented to equity in educational institutions in Metropolitan Area of Buenos Aires (Argentina). As result, we detected heterogeneous experiences and willingness to set new practices up. But there are factors limiting the change: deep-rooted cultural customs; shortcomings in terms of teacher training; in public policies a lack of clarity about environmental education objectives, curricular approach and pedagogical devices. Fragmented and naturalists approaches, and lack of a critical perspective prevail. At the institutional level, the relevance of implementing sustainable practices in classroom is discussed. Perceptions also operate as obstacles. All this hinders the adoption of new environmental education actions and the momentum needed to sustain them over time.Fil: Saidon, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; ArgentinaFil: Claverie, Julieta Andrea. Universidad Nacional de Tres de Febrero. Nucleo Interd de Formación y Est P/e/des D/l/educ; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

El e-portafolios y los estilos de aprendizaje.Una experiencia en la formación inicial de maestros

Presentamos una experiencia realizada con el Portafolio Electrónico en la Escuela Universitaria de Magisterio ESCUNI, adscrita a la Universidad Complutense de Madrid. En una asignatura básica del plan de estudios se ha optado por una metodología activa que incluye la aplicando del recurso didáctico "portafolio electrónico en soporte digital". Se ha aplicado a cuatro grupos de primer curso del Grado de Maestro en Educación Infantil o Educación Primaria. Se han analizado los resultados académicos y su relación con los Estilos de Aprendizaje de los estudiantes. Y se ha podido apreciar cómo incide su uso en los resultados académicos obtenidos y en la satisfacción percibida por un importante número de los alumnos tras su realización. Se ha utilizado una metodología de corte cuantitativa, complementada con un análisis cualitativo, que permite no sólo describir e inferir datos sino también conocer las sensaciones que experimentan los estudiantes ante lo que para ellos es una novedad a la hora de construir su aprendizaje y en la forma de ser evaluados

Diversity of the nitrite reductase gene nirS in the sediment of a free-water surface constructed wetland

The diversity of the nitrite reductase gene nirS was studied in the bulk sediment of a free-water surface constructed wetland (FWS-CW) located next to the Empuriabrava wastewater treatment plant (WWTP), in Castelló d’Empúries (Girona, NE Spain). The study period extended from the inception of the treatment wetland, in June 1998, until March 1999 and comprised periods of relatively high nitrate and ammonium concentrations at the influent and low nitrate-removal efficiencies. To evaluate nirS diversity, partial gene sequences were obtained by cloning of the respective PCR products. Rarefaction curves based on DOTUR analyses of the deduced amino-acid sequences predicted a greater diversity of nirS genes in samples containing higher ammonium concentrations. Estimated Shannon-Weaver indices of the four cloned samples showed a positive relationship with the N-NH4 +/N-NO3− ratios measured at the FWS-CW inlet. Identities between the deduced amino-acid sequences and those previously deposited in public databases ranged from 72 to 97%. Phylogenetic analysis based on these deduced sequences grouped 165 nirS clones in seven main clusters according to high similarity indices. Up to 60% of the clones clustered together in a highly homogeneous group with little homologies to any sequence retrieved from cultured representatives. Moreover, prevailing environmental conditions appeared to select for particular denitrifying populations, e.g., with respect to ammonium load and nitrogen removal efficiencies. This observation is of particular interest for the management of treatment wetlands, in which only slight variations in the theoretical denitrification potential of the system can occurThis research has been funded by the Spanish Ministry of Education and Science (grants REN2003-02185 and CGL2006-02382