3 research outputs found
Efectos del aprendizaje en el proceso de educación virtual durante la pandemia Covid19 en una institución educativa
Nuestro estudio se centra en los efectos del proceso de educación virtual durante
la pandemia Covid19 en una institución educativa en una provincia de Ecuador,
en un intento de mostrar cómo han respondido docentes y estudiantes a este
tipo de aprendizaje en el marco de la pandemia. La Universidad César Vallejo,
al igual que otras universidades de todo el mundo, suspendieron las clases
presenciales y pasaron a la enseñanza en línea, lo que supone un gran reto para
docentes y discentes. Aunque supone un cambio en la difusión de saberes,
monitoreo y evaluación, permite el desarrollo de competencias y habilidades
digitales específicas. Sin embargo, cabe preguntarse si con los equipos para la
enseñanza, entre docentes y estudiantes, se aprovecha la explosión de
información en la era de Internet, y cómo han respondido a la necesidad de
aprendizaje en línea. Estas nociones predefinidas, fueron planteadas en
silogismos en el marco teórico; haciendo referencia a la realidad circundante
entre docentes y estudiantes de una institución educativa en ecuador en el
periodo posterior al encierro.
La repentina agitación causada por la pandemia de Covid-19 ha provocado
trastornos contextuales sin precedentes a escala mundial. De los encuentros
físicos a los virtuales, del trabajo en la oficina al teletrabajo, de la enseñanza
presencial a la a distancia, las distintas facetas de estos ámbitos se están
replanteando para frenar la propagación de Covid-19 y garantizar la seguridad
de todos. En la enseñanza escolar, esto supuso un trastorno pedagógico: se
cerraron rápidamente las universidades y se pidió a los profesores que dieran
"continuidad pedagógica" y a los estudiantes que siguieran aprendiendo desde
casa. El aprendizaje electrónico sustituyó de repente al presencial y se convirtió
en la norma. De este modo, los profesores y los alumnos se enfrentaron a nuevas
limitaciones: aislamiento, falta de recursos, acceso limitado... etc
Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials
Aims:
The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials.
Methods and Results:
Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594).
Conclusions:
GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation
Cardiac myosin activation with omecamtiv mecarbil in systolic heart failure
BACKGROUND The selective cardiac myosin activator omecamtiv mecarbil has been shown to improve cardiac function in patients with heart failure with a reduced ejection fraction. Its effect on cardiovascular outcomes is unknown. METHODS We randomly assigned 8256 patients (inpatients and outpatients) with symptomatic chronic heart failure and an ejection fraction of 35% or less to receive omecamtiv mecarbil (using pharmacokinetic-guided doses of 25 mg, 37.5 mg, or 50 mg twice daily) or placebo, in addition to standard heart-failure therapy. The primary outcome was a composite of a first heart-failure event (hospitalization or urgent visit for heart failure) or death from cardiovascular causes. RESULTS During a median of 21.8 months, a primary-outcome event occurred in 1523 of 4120 patients (37.0%) in the omecamtiv mecarbil group and in 1607 of 4112 patients (39.1%) in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.86 to 0.99; P = 0.03). A total of 808 patients (19.6%) and 798 patients (19.4%), respectively, died from cardiovascular causes (hazard ratio, 1.01; 95% CI, 0.92 to 1.11). There was no significant difference between groups in the change from baseline on the Kansas City Cardiomyopathy Questionnaire total symptom score. At week 24, the change from baseline for the median N-terminal pro-B-type natriuretic peptide level was 10% lower in the omecamtiv mecarbil group than in the placebo group; the median cardiac troponin I level was 4 ng per liter higher. The frequency of cardiac ischemic and ventricular arrhythmia events was similar in the two groups. CONCLUSIONS Among patients with heart failure and a reduced ejection, those who received omecamtiv mecarbil had a lower incidence of a composite of a heart-failure event or death from cardiovascular causes than those who received placebo. (Funded by Amgen and others; GALACTIC-HF ClinicalTrials.gov number, NCT02929329; EudraCT number, 2016 -002299-28.)