The social media debate on the educational use of smartphones. Discourses of promotion and prohibition

Pedro C. Mellado Moreno – Universidad Rey Juan Carlos - 0000-0001-8982-2120Josefina Patiño Masó – Universitat de Girona - 0000-0002-2322-2437Francisco J. Ramos Pardo – Universidad de Castilla-La Mancha - 0000-0003-4989-7931Meritxell Estebanell Minguell – Universitat de Girona - 0000-0002-6576-3207Recepción: 16.06.2022 | Aceptado: 25.10.2022Correspondencia a través de ORCID: Pedro C. Mellado-Moreno - 0000-0001-8982-2120Financiación: La presente investigación se enmarca en el proyecto «Jóvenes y móviles en el aula. Discursos y dinámicas de prohibición, promoción e indeterminación» PID2019-108041RB-100, financiado por el Ministerio de Ciencia e Innovación del Gobierno de España/Agencia Estatal de Investigación/10.13039/501100011033.2020-2023Área o categoría del conocimiento: MultidisciplinarEditora: Diana Marín Suelves - Universidad de Valencia - ORCID: 0000-0002-5346-8665Revisión por pares abierta: Tania Caamaño Liñares - 0000-0003-0597-2645Revisión por pares abierta: Ángel Emiro Páez Moreno - 0000-0002-0924-3506Las redes sociales se han convertido en uno de los medios con mayor influencia en el debate actual y la opinión pública. Las cuestiones controvertidas en educación, como es el uso de los móviles con fines educativos, no son ajenas a esta capacidad de influencia. El objetivo de este estudio es identificar las principales ideas y argumentos comunicados en medios y redes sociales asociados a la promoción o prohibición del uso del móvil en el aula Para conocer el estado de esta cuestión se ha optado por emplear el motor de búsqueda de Google en las plataformas de las principales redes sociales. Los resultados ratifican la presencia de este debate en redes sociales, que suele estar protagonizado por perfiles docentes y perfiles de medios de comunicación, así como la confrontación de argumentos que giran en torno a la promoción o prohibición. Los perfiles educativos tienden a mostrar una posición favorable hacia el uso de los móviles en el aula, frente a los perfiles de medios de comunicación. Los argumentos asociados a la promoción se centran en el aprovechamiento del potencial educativo de los móviles, mientras que los discursos de prohibición alertan de la capacidad distractora del móvil y su papel en las situaciones de acoso escolar.Abstract: Social networks have become one of the most influential media in public debate and opinion. Controversial issues in education, such as the use of mobile phones in the classroom, are no stranger to this capacity for influence. The main goal of this study is to identify the principal ideas and arguments in media and social networks associated with the promotion or prohibition of educational mobile phones use in classroom. In order to find out the state of this issue, we have chosen to use the Google search engine on the platforms of the main social networks. The results confirm the presence of this debate on social networks, which tends to be led by educational profiles and media profiles, as well as the confrontation of arguments revolving around promotion or prohibition. Educational profiles tend to show a favorable position towards the use of mobiles in the classroom, compared to media profiles. The arguments associated with promotion focus on the educational potential of mobiles, while the prohibition discourses warn of the distracting capacity of mobiles and their role in bullying situations.Universidad Rey Juan CarlosUniversitat de GironaUniversidad de Castilla la ManchaUniversitat de GironaXXIX Jornadas Internacionales Universitarias de Tecnología Educativa - JUTE 202

Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision

Comparison of seven prognostic tools to identify low-risk pulmonary embolism in patients aged <50 years

publishersversionPeer reviewe

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

Influència dels filtres de vena cava inferior sobre la pràctica clínica en la malaltia tromboembòlica venosa

Introducció: Tot i que les guies de pràctica clínica recomanen l'ús d'un filtre de vena cava inferior (FVCI) en pacients amb un episodi agut de malaltia tromboembòlica venosa (MTEV) i contraindicacions per al tractament anticoagulant o un episodi de sagnat major durant els primers tres mesos de tractament anticoagulant, no existeixen assajos clínics ni estudis aleatoritzats que avaluïn l'eficàcia i seguretat dels filtres de vena cava inferior (FVCI) en les anomenades 'indicacions absolutes'. Objectius: Avaluar l'eficàcia d'un FVCI en pacients que desenvolupen un episodi de MTEV recurrent malgrat un correcte tractament anticoagulant i en pacients amb MTEV aguda que presenten un episodi de sagnat major durant el tractament anticoagulant. Material i mètodes: A partir de la cohort RIETE (Registro Informatizado de la Enfermedad Tromboembólica) s'ha realitzat un estudi de casos i controls on, mitjançant l'anàlisi per aparellament per propensity score, s'ha valorat l'associació entre 1) la inserció d'un FVCI per una MTEV recurrent i la mortalitat global, mortalitat per tromboembòlia pulmonar (TEP), nous episodis de MTEV i episodis de sagnat major a 30 dies després de l'episodi de recidiva, 2) la inserció d'un FVCI en pacients amb un episodi de sagnat major durant els primers tres mesos de tractament anticoagulant per MTEV i la mortalitat global, mortalitat per sagnat, nous episodis de sagnat o de MTEV. Resultats: Els pacients que van presentar un episodi recurrent de MTEV malgrat un correcte tractament anticoagulant es varen analitzar en funció del tipus de recidiva: trombosi venosa profunda (TVP) o TEP. Dels pacients que van recidivar en forma de TVP, 17 pacients portadors d'un FVCI van ser aparellats amb 49 pacients tractats sense FVCI; l'anàlisi per aparellament no va mostrar diferències pel que fa a mortalitat global entre pacients portadors de FVCI respecte no portadors de FVCI (17.7% vs 12.2%). Dels pacients que van recidivar en forma de TEP, 48 pacients tractats amb un FVCI van ser aparellats amb 91 pacients sense FVCI; l'anàlisi va mostrar una disminució significativa de la mortalitat global en els pacients portadors de FVCI (2.1% vs 25.3%; p=0.002) i una disminució no significativa de la mortalitat per TEP. Entre els pacients que van presentar un episodi de sagnat major durant els primers tres mesos de tractament anticoagulant i van ser tractats amb la inserció d'un FVCI, 122 pacients tractats amb la inserció d'un FVCI van ser aparellats amb 429 pacients sense FVCI; la inserció d'un FVCI es va associar a una disminució significativa de la mortalitat global (HR 0.49; IC 95% 0.31-0.77) i del sagnat fatal (HR 0.16; IC 95% 0.07-0.49), amb un risc similar de nous episodis de sagnat i de TEP recurrent. Conclusions: 1. L'ús d'un FVCI en pacients amb un episodi de TEP recurrent malgrat un correcte tractament anticoagulant s'associa a una disminució de la mortalitat global, sense observar-se aquest efecte en pacients que presenten una recidiva en forma de TVP. 2. En pacients que presenten un episodi de sagnat major durant els primers 3 mesos de tractament anticoagulant per MTEV, l'ús d'un FVCI s'associa a una disminució de la mortalitat global i de la mortalitat per sagnat.Introducción: Aunque las guías de práctica clínica recomiendan el uso de un filtro de vena cava inferior (FVCI) en pacientes con un episodio agudo de enfermedad tromboembólica venosa (ETEV) y contraindicaciones para el tratamiento anticoagulante o un episodio de sangrado mayor, no existen ensayos clínicos ni estudios randomizados que evalúen la eficacia y seguridad de los FVCI en las llamadas "indicaciones absolutas". Objetivos: Evaluar la eficacia de un FVCI en pacientes con un episodio recurrente de ETEV a pesar de un correcto tratamiento anticoagulante y en pacientes con ETEV aguda que presentan un episodio de sangrado mayor durante el tratamiento anticoagulante. Material y métodos: A partir de la cohorte RIETE (Registro Informatizado de la Enfermedad Tromboembólica) se ha realizado un estudio de casos y controles donde, mediante el análisis por propensity score matching, se ha evaluado la asociación entre 1) la inserción de un FVCI por ETEV recurrente y la mortalidad global, mortalidad por tromboembolismo pulmonar (TEP), nuevos episodios de ETEV y episodios de sangrado mayor a 30 días tras el episodio de recidiva y 2) la inserción de un FVCI en pacientes con un episodio de sangrado mayor durante los primeros tres meses de tratamiento anticoagulante por ETEV aguda y la mortalidad global, mortalidad por sangrado, nuevos episodios de sangrado o de ETEV. Resultados Los pacientes que presentaron un episodio de ETEV recurrente a pesar de un correcto tratamiento anticoagulante se analizaron en función del tipo de recidiva: trombosis venosa profunda (TVP) o TEP. De los pacientes que recidivaron en forma de TVP, 17 pacientes portadores de un FVCI se aparearon con 49 pacientes tratados sin FVC; el análisis por apareamiento no mostró diferencias en la mortalidad global entre los pacientes portadores de FVCI respecto a los no portadores de FVCI (17.7% vs 12.2%). De los pacientes que recidivaron en forma de TEP, 48 pacientes tratados con un FVCI se aparearon con 91 pacientes sin FVCI; el análisis mostró una disminución significativa de la mortalidad global en los pacientes portadores de un FVCI (2.1% vs 25.3%; p=0.002) y una disminución no significativa de la mortalidad por TEP. Entre los pacientes que presentaron un episodio de sangrado mayor durante los primeros tres meses de tratamiento anticoagulante y fueron tratados con la inserción de un FVCI, 122 pacientes tratados con la inserción de un FVCI fueron apareados con 429 pacientes sin FVCI; la inserción de un FVCI se asoció a una disminución significativa de la mortalidad global (HR 0.49; IC 95% 0.31-0.77) y del sangrado fatal (HR 0.16; IC 95% 0.07-0.49), con un riesgo similar de nuevos episodios de sangrado mayor y TEP recurrente. Conclusiones: 1. El uso de un FVCI en pacientes con TEP recurrente a pesar de un correcto tratamiento anticoagulante se asocia a una disminución de la mortalidad global, sin observarse este efecto en pacientes que presentan una recidiva en forma de TVP. 2. En pacientes que presentan un episodio de sangrado mayor durante los primeros tres meses de tratamiento anticoagulante por ETEV, el uso de un FVCI se asocia a una disminución de la mortalidad global y la mortalidad por sangrado.Introduction Even though guidelines recommend the use of inferior vena cava filters (IVCF) in patients with acute venous thromboembolism (VTE) and a contraindication for anticoagulant treatment or a recurrent VTE despite adequate anticoagulant treatment, there are no randomized trials or cohort studies testing the influence of an IVCF in such indications. Objectives To assess the influence of an IVCF insertion in VTE patients with 1) an episode of recurrent venous thromboembolism (VTE) despite adequate anticoagulant treatment, or 2) a major bleeding event during the first 3 months of anticoagulant treatment. Material and methods Among a cohort of VTE patients recruited in the RIETE (Registro Informatizado de la Enfermedad Tromboembólica), registry, we performed a case-control study (propensity score matching) to assess the association between IVCF insertion in patients with a recurrent VTE episode and all-cause mortality, fatal pulmonary embolism (PE), recurrent VTE and major bleeding. Additionally we analyzed the effect of an IVCF insertion on all-cause mortality, fatal bleeding, re-bleeding or recurrent VTE in patients who developed major bleeding during the first 3 months of anticoagulant therapy. Results: Patients with recurrent VTE were divided according to type of recurrence: deep venous thrombosis (DVT) or PE. Among patients with a recurrent DVT, 17 patients with an IVCF were matched with 49 patients without filter; the insertion of an IVCF did not reduce all-cause mortality rates (17.7% vs 12.2%). Among patients with a recurrent PE, 48 patients with an IVCF inserted were matched with 91 patients without filter; the insertion of an IVFC was associated with a significant decrease in all-cause mortality rate (2.1% vs 25.3%; p=0.002) and a non-significant lower rate of fatal PE (2.1% vs 17.6%). Among VTE patients with a major bleeding event during the first 3 months of anticoagulant treatment, 122 patients with an IVCF inserted were matched with 429 patients without filtre. The insertion of an IVCF was associated with a lower all-cause mortality (HR 0.49; 95% CI 0.31-0.77) and fatal bleeding (HR 0.16; 95% CI 0.07-0.49) risk, with a similar re-bleeding and recurrent PE rates. Conclusions: Among patients with a VTE recurrence during the first 3 months of anticoagulant therapy insertion of an IVCF was not associated with a survival benefit in patients with recurrent DVT, but reduced the risk of all-cause mortality in patients with recurrent PE. The insertion of an IVCF in patients with a major bleeding event during the first 3 months of anticoagulant therapy for a VTE was associated with a lower risk of all-cause mortality and fatal bleeding

Contrasting Adult Body-Size in Sister Populations of the Balearic Lizard, Podarcis lilfordi (Günther 1874) Suggests Anthropogenic Selective Pressures

Este artículo contiene 12 páginas, 5 figuras, 5 tablas.Recently isolated populations offer a good biological model to infer the evolutionary forces responsible for the current divergences across populations. We coupled genetic, morphometric, ecological, and demographic analyses from three island populations of the endemic Balearic Wall Lizard, Podarcis lilfordi, (Balearic archipelago, Spain) to infer the mechanisms underlying the observed differences in body size. For each population, we described plant community structure, derived a biotic capacity index, and used individual-based data on 1369 lizards captured and released during 6 yr (2009–2015) to estimate population density and body growth patterns. We used genetic data collected on 80 individuals (~27 for each population) to infer genetic divergences across islets and population history. Body size divergences cannot be explained by the ecological or population characteristics. Individual growth was slower in the smallest island, where lizards reached the largest average body size. In addition to having the highest density, results suggested that resource availability does not constrain asymptotic body size, but the speed at which individuals reach it does. The Approximate Bayesian Computation used to infer population history from genetic data supported the occurrence of two bottlenecks in the islet with the highest anthropogenic footprint. We emphasize the need to integrate ecological and genetic data and the importance of considering the effects of past human disturbance as an additional force in being able to model present island fauna.GT was supported by I. Hendriks. AR was supported by a JAE fellowship from the Spanish Council of Research. Ethics Committee for Animal Experimentation (CEEA) of Balearic Islands University (Spain) approved the protocol. The authorization to capture and handing animals was given by the Balearic Islands Government (ref: CEP 06/2015).Peer reviewe

Outcomes Associated With Inferior Vena Cava Filters Among Patients With Thromboembolic Recurrence During Anticoagulant Therapy.

OBJECTIVES The aim of this study was to assess the effectiveness of inferior vena cava (IVC) filter use among patients who develop recurrent symptomatic venous thromboembolism (VTE) on anticoagulant therapy. BACKGROUND There is a lack of efficacy evidence of IVC filter therapy in patients with VTE recurrence on anticoagulant therapy. METHODS In this cohort study of patients with acute VTE identified from the RIETE (Registro Informatizado de la Enfermedad Tromboembólica) registry, the associations between IVC filter placement for VTE recurrence in the first 3 months of anticoagulant therapy and the outcomes of all-cause mortality, pulmonary embolism (PE)-related mortality, second recurrent VTE, and major bleeding rates through 30 days after diagnosis of recurrence were assessed. RESULTS Among 17 patients treated with filters and 49 matched patients treated without filters for VTE recurrence that presented as deep vein thrombosis, propensity score-matched groups showed no significant differences in death for filter insertion compared with no insertion (17.7% vs. 12.2%; p = 0.56). Among 48 patients treated with filters and 91 matched patients treated without filters for VTE recurrence that presented as PE, propensity score-matched groups showed a significant decrease in all-cause death for filter insertion compared with no insertion (2.1% vs. 25.3%; p = 0.02). The PE-related mortality rate was not significantly lower for filter insertion than no insertion (2.1% vs. 17.6%; p = 0.08), though the point estimates markedly differed. CONCLUSIONS Among patients with VTE recurrence during the first 3 months of anticoagulant therapy, IVC filter insertion was not associated with a survival benefit in patients who recurred with deep vein thrombosis, although it was associated with a lower risk for all-cause death in patients who recurred with PE

Persistent cutaneous abdominal ulcerations secondary to diffuse dermal angiomatosis: an underestimated sign for severe atherosclerosis: A case report.

BACKGROUND: Diffuse dermal angiomatosis (DDA) is a rare, acquired, reactive vascular proliferation, clinically characterized by livedoid erythematous-violaceous plaques, which frequently evolve to ulceration and necrosis. Histopathologically, it is manifested by a diffuse proliferation of endothelial cells within the full thickness of the dermis. DDA has been mainly associated with severe peripheral atherosclerosis. METHODS: We report a 63-year-old woman who presented with multiple erythematous-violaceous plaques with central deep skin ulcers on thighs, lower abdomen, and perianal area, associated with intermittent claudication, low-grade fever, and weight loss. Initially, the clinical picture along with positive cultures for Klebsiella pneumoniae suggested a multifocal ecthyma gangrenosum; nevertheless, a skin biopsy showed a diffuse dermal proliferation of endothelial cells interstitially arranged between collagen bundles. A computed tomography scan revealed severe aortic atheromatosis with complete luminal occlusion of the infrarenal aorta and common iliac arteries. RESULTS: The diagnosis of DDA secondary to severe atherosclerosis was established. The patient underwent a left axillofemoral bypass surgery with a rapidly healing of the ulcers in the next weeks./nCONCLUSIONS: DDA should be considered in the differential diagnosis of livedoid ischemic lesions. Recognition of DDA as a cutaneous sign of severe peripheral vascular disease is important for both dermatologists and internists. Recognition of risk factors and their management with an early intervention to correct tissue ischemia can be curative

Long-Term Anticoagulant Therapy of Patients with Venous Thromboembolism. What Are the Practices?

Current guidelines of antithrombotic therapy suggest early initiation of vitamin K antagonists (VKA) in non-cancer patients with venous thromboembolism (VTE), and long-term therapy with low-molecular weight heparin (LMWH) for those with cancer. We used data from RIETE (international registry of patients with VTE) to report the use of long-term anticoagulant therapy over time and to identify predictors of anticoagulant choice (regarding international guidelines) in patients with- and without cancer. Among 35,280 patients without cancer, 82% received long-term VKA (but 17% started after the first week). Among 4,378 patients with cancer, 66% received long term LMWH as monotherapy. In patients without cancer, recent bleeding (odds ratio [OR] 2.70, 95% CI 2.26-3.23), age >70 years (OR 1.15, 95% CI 1.06-1.24), immobility (OR 2.06, 95% CI 1.93-2.19), renal insufficiency (OR 2.42, 95% CI 2.15-2.71) and anemia (OR 1.75, 95% CI 1.65-1.87) predicted poor adherence to guidelines. In those with cancer, anemia (OR 1.83, 95% CI 1.64-2.06), immobility (OR 1.51, 95% CI 1.30-1.76) and metastases (OR 3.22, 95% CI 2.87-3.61) predicted long-term LMWH therapy. In conclusion, we report practices of VTE therapy in real life and found that a significant proportion of patients did not receive the recommended treatment. The perceived increased risk for bleeding has an impact on anticoagulant treatment decision.This Registry is supported by unrestricted educational grants from Sanofi Spain and Bayer Pharma AG. The funding source had no role in the design, protocol development, or conduct of the study; data collection, management, or analysis; interpretation, preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. The RIETE Registry was supported with an unrestricted educational grant from Sanofi Spain and Bayer Pharma AG. Bayer Pharma AG’s support was limited to the part of RIETE outside Spain, which accounts for a 20.05% of the total patients included in the RIETE Registry. The authors have nothing to disclose. The authors have declared that no competing interests exist