Easix Score Correlates With Endothelial Dysfunction Biomarkers and Predicts Risk of Acute Graft-Versus-Host Disease After Allogeneic Transplantation

Plasma biomarkers of endothelial dysfunction have been postulated for the diagnosis and prognosis of acute graft-versus-host disease (aGVHD). However, their use is not validated in clinical practice yet. The endothelial activation and stress index (EASIX), a simple score based on routine laboratory parameters, is considered to be an indirect marker of endothelial damage. High value of EASIX was correlated with worse non-relapse mortality (NRM) and overall survival (OS) and a high risk of sinusoidal obstructive syndrome (SOS) and transplant-associated thrombotic microangiopathy (TA-TMA).This study investigates the predictive value of plasma biomarkers and the EASIX score for the prediction of aGVHD.We assessed VCAM-1, TNFR1, and VWF:Ag plasma levels, and EASIX score before allogeneic hematopoietic stem cell transplantation (allo-HSCT), and on days 0, +3, +7, +14, and +21 in an experimental cohort (n=33). EASIX was transformed to a base-2 logarithm to perform the analysis. For the most relevant biomarkers, we estimate the optimal cut-off values and the discriminatory ability to differentiate patients with high-risk of aGVHD. The conclusions obtained in the experimental cohort were validated in a large cohort of 321 patients at the same institution.Plasma biomarkers and EASIX showed similar post-transplant dynamics consisting of a progressive increase. Multivariate analysis showed an association between high TNFR1 levels and Log-2 EASIX score on day +7 post-transplant with an increased likelihood of developing aGVHD (HR 1, P=0.002; HR 2.31, P=0.013, respectively). Patients with TNFR1 ≥1300 ng/mL (HR 7.19, P=0.006) and Log2-EASIX ≥3 (HR 14.7, P<0.001) at day +7 post-transplant were more likely to develop aGVHD with high predictive accuracy (C-index of 74% and 81%, respectively). In the validation cohort, patients with Log2-EASIX ≥ 3 on day +7 post-transplant presented a significantly higher incidence of grade II-IV aGVHD (HR 1.94, P=0.004) independent of GVHD prophylaxis (HR 0.38, P=0.004), conditioning regimen (HR 0.59, P=0.02) and type of donor (HR 2.38, P=0.014).Differential degree of endothelial damage can be measured using both EASIX score and plasma biomarkers in the early post-transplant period. Patients at risk of developing aGVHD could be easily identified by a high EASIX score. Both indicators of endothelial activation represent a promising approach to predict aGVHD.Published by Elsevier Inc

Innovative open technology for an inclusive, accessible university applied to Optometry practices

Poner la última tecnología similar a la innovación en el sector de la Optometría para atención primaria a pacientes teniendo en cuanta la inserción laboral, inclusión y accesibilidad utilizando competencias digitales simples en interacción en la nube.Putting the latest technology similar to innovation in the Optometry sector for primary care for patients taking into account job placement, inclusion and accessibility using simple digital skills in interaction in the cloud.Depto. de Optometría y VisiónFac. de Óptica y OptometríaFALSEsubmitte

The hyper-classroom in the teaching of subjects related to Optics and Optometry

En los últimos años, las metodologías educativas se orientan hacia un mayor protagonismo del alumno, su papel como agente y su responsabilidad en el proceso de aprendizaje. Esto se puso especialmente de manifiesto en el sistema universitario español al producirse la incorporación del mismo al Espacio Europeo de Educación Superior (EEES). Las necesidades docentes para estas nuevas metodologías son diferentes a las de otras más tradicionales como la clase magistral, en la que el alumno tiene un papel pasivo como receptor de información. En el último curso, se ha sumado un factor añadido a la forma de impartir docencia, siendo este la necesidad de hacer partícipes de la clase no solo a alumnos que se encuentran en la misma aula que el profesor, sino también a otros conectados de manera online (enseñanza híbrida). La introducción de recursos y materiales físicos y digitales que permitan la adaptabilidad a situaciones y necesidades diversas y actuales es, por tanto, imprescindible, además de natural en nuestra sociedad. Para que estos cambios metodológicos puedan producirse con eficacia, deben ser acompañados de un cambio en el entorno de aprendizaje y sus recursos, ya que estos pueden ser un elemento limitante o favorecedor de la dinámica didáctica que se produce dentro del aula. La hiperaula presenta un espacio flexible que puede adaptarse a técnicas, métodos y metodologías múltiples, tanto tradicionales como recientes, así como unos recursos que permiten llevarlos a cabo.In recent years, educational methodologies are oriented towards a greater role of the student, his role as an agent and his responsibility in the learning process. This was especially evident in the Spanish university system when it was incorporated into the European Higher Education Area (EHEA). The teaching needs for these new methodologies are different from those of more traditional ones such as the master class, in which the student has a passive role as receiver of information. In the last year, an added factor has been added to the way of teaching, this being the need to involve in the class not only students who are in the same classroom as the teacher, but also others connected in a way online (hybrid teaching). The introduction of resources and physical and digital materials that allow adaptability to diverse and current situations and needs is, therefore, essential, as well as natural in our society. For these methodological changes to occur effectively, they must be accompanied by a change in the learning environment and its resources, since these can be a limiting or favorable element of the didactic dynamics that occurs within the classroom. The hyper-classroom presents a flexible space that can be adapted to multiple techniques, methods and methodologies, both traditional and recent, as well as resources that allow them to be carried out.Depto. de Optometría y VisiónFac. de Óptica y OptometríaFALSEsubmitte