La interacción didáctica como objeto de investigación del ejercicio docente en la formación de expertos en la educación superior abierta y a distancia

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Effect of orthodontic treatment involving first premolar extractions on mandibular third molar angulation and retromolar space

Third molars present more problems than other teeth because they are the last teeth to erupt, and so it is important to assess their development when designing an orthodontic treatment plan. The aim of this study was to compare the angulation of the mandibular third molar and retromolar space before and after orthodontic treatment in cases involving first premolar extraction. 76 patients, 59 women (77.63%) and 17 men (22.36%), were recruited from the Orthodontics Clinic at Benemérita Universidad Autónoma de Puebla (Mexico). Panoramic radiographs were analyzed before and after orthodontic treatment that included first premolar extractions, measuring retromolar space (RS) and the angles formed by the intersection of the axes of the third and second molar (?) and the intersection of the axis of the mandibular plane and third molar (?). The data obtained underwent statistical analysis. The angle ? and ? showed statistically significant differences on the left side in women. In men, only the right side ? angle showed significant differences. Retromolar space increased significantly on both sides for both sexes. Third molar angulation presents different behaviors between men and women, with greater verticalization in women

Obstetric profile of pregnant adolescents in a public hospital: risk at beginning of labor, at delivery, postpartum, and in puerperium

Objetivo: escribir el perfil obstétrico de las adolescentes al inicio del trabajo de parto, durante el parto, el posparto y el puerperio.Método: estudio descriptivo transversal, con 85 adolescentes embarazadas elegidas por conveniencia, referidas de los Centros de Salud a un Hospital Público en la Ciudad de México. Fue evaluado el riesgo antes, durante, después del parto y en el puerperio, medidos respectivamente con los "Previgenes" que componen el Sistema de Evaluación de Riesgo Reproductivo y Perinatal.Resultados: el nivel socioeconómico, la ocupación y la escolaridad influyeron en la emotividad de las adolescentes ante el trabajo de parto, cuyo riesgo obstétrico fue de 55% bajo, 35% medio y 10% alto. El riesgo en el parto fue bajo en 55%, medio en 18% y alto en 27%. El riesgo en el posparto fue 50% riesgo bajo, 25% riesgo medio y 25% riesgo alto. En el puerperio, la mayoría de las adolescentes (90%) presentó riesgo bajo.Conclusión: la mayoría de las adolescentes presentaron bajo riesco en las etapas avaluadas. El estudio contribuyó a identificar las estrategias para el abordaje de riesgos por la vulnerabilidad propia en este tipo de población y favoreció la realización de intervenciones acorde a sus necesidades.Objective: describe the obstetric profile of adolescents at beginning of labor, at delivery, postpartum, and in puerperium.Method: Cross-sectional descriptive study with 85 pregnant adolescents, selected by convenience, referred by health centers to a public hospital in Mexico City. Risks were evaluated before, during and after delivery and in puerperium, and measured respectively with the "Previgenes" that compose the Reproductive and Perinatal Risk Assessment System.Results: socioeconomic status, occupation and education level had influence on the emotionality of adolescents in relation to labor, whose obstetric risk was low for 55%, medium for 35%, and high for 10%. Risk in labor was low for 55%, medium for 18%, and high for 27%. Risk postpartum was low for 50%, medium for 25%, and high for 25%. In puerperium, most adolescents (90%) had low risk.Conclusion: most adolescents had low risk in the stages evaluated. The study contributed to identify strategies to approach risk considering the vulnerability inherent in this type of population and favored the conduct of appropriate interventions for the respective needs.Objetivo: descrever o perfil obstétrico das adolescentes no início do trabalho de parto, durante o parto, pós-parto e puerpério.Método: estudo descritivo transversal, com 85 adolescentes grávidas, escolhidas por conveniência, encaminhadas dos Centros de Saúde a um Hospital Público na Cidade do México. Foram avaliados os riscos antes, durante e depois do parto e no puerpério, medidos respectivamente com os "Previgenes" que compõem o Sistema de Avaliação de Risco Reprodutivo e Perinatal.Resultados: o nível socioeconômico, a ocupação e a escolaridade tiveram influência sobre a emotividade das adolescentes em relação ao trabalho de parto, cujo risco obstétrico foi 55% baixo, 35% médio e 10% alto. O risco no trabalho de parto foi baixo em 55%, médio em 18% e alto em 27%. O risco no pós-parto foi de 50% risco baixo, 25% risco médio e 25% risco alto. No puerpério, a maioria das adolescentes (90%) apresentou baixo risco.Conclusão: a maioria das adolescentes apresentou baixo risco nas etapas avaliadas. O estudo contribuiu para identificar estratégias para a abordagem de riscos devido à vulnerabilidade inerente a este tipo de população e favoreceu a realização de intervenções adequadas para as suas necessidades

Overexpression of AtGRDP2, a novel glycine-rich domain protein, accelerates plant growth and improves stress tolerance

"Proteins with glycine-rich signatures have been reported in a wide variety of organisms including plants, mammalians, fungi, and bacteria. Plant glycine-rich protein genes exhibit developmental and tissue-specific expression patterns. Herein, we present the characterization of the AtGRDP2 gene using Arabidopsis null and knockdown mutants and, Arabidopsis and lettuce over-expression lines. AtGRDP2 encodes a short glycine-rich domain protein, containing a DUF1399 domain and a putative RNA recognition motif (RRM). AtGRDP2 transcript is mainly expressed in Arabidopsis floral organs, and its deregulation in Arabidopsis Atgrdp2 mutants and 35S::AtGRDP2 over-expression lines produces alterations in development. The 35S::AtGRDP2 over-expression lines grow faster than the WT, while the Atgrdp2 mutants have a delay in growth and development. The over-expression lines accumulate higher levels of indole-3-acetic acid and, have alterations in the expression pattern of ARF6, ARF8, and miR167 regulators of floral development and auxin signaling. Under salt stress conditions, 35S::AtGRDP2 over-expression lines displayed higher tolerance and increased expression of stress marker genes. Likewise, transgenic lettuce plants over-expressing the AtGRDP2 gene manifest increased growth rate and early flowering time. Our data reveal an important role for AtGRDP2 in Arabidopsis development and stress response, and suggest a connection between AtGRDP2 and auxin signaling.

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Evaluation of factors leading to poor outcomes for pediatric acute lymphoblastic leukemia in Mexico: a multi-institutional report of 2,116 patients

Background and aimsPediatric acute lymphoblastic leukemia (ALL) survival rates in low- and middle-income countries are lower due to deficiencies in multilevel factors, including access to timely diagnosis, risk-stratified therapy, and comprehensive supportive care. This retrospective study aimed to analyze outcomes for pediatric ALL at 16 centers in Mexico.MethodsPatients &lt;18 years of age with newly diagnosed B- and T-cell ALL treated between January 2011 and December 2019 were included. Clinical and biological characteristics and their association with outcomes were examined.ResultsOverall, 2,116 patients with a median age of 6.3 years were included. B-cell immunophenotype was identified in 1,889 (89.3%) patients. The median white blood cells at diagnosis were 11.2.5 × 103/mm3. CNS-1 status was reported in 1,810 (85.5%), CNS-2 in 67 (3.2%), and CNS-3 in 61 (2.9%). A total of 1,488 patients (70.4%) were classified as high-risk at diagnosis. However, in 52.5% (991/1,889) of patients with B-cell ALL, the reported risk group did not match the calculated risk group allocation based on National Cancer Institute (NCI) criteria. Fluorescence in situ hybridization (FISH) and PCR tests were performed for 407 (19.2%) and 736 (34.8%) patients, respectively. Minimal residual disease (MRD) during induction was performed in 1,158 patients (54.7%). The median follow-up was 3.7 years. During induction, 191 patients died (9.1%), and 45 patients (2.1%) experienced induction failure. A total of 365 deaths (17.3%) occurred, including 174 deaths after remission. Six percent (176) of patients abandoned treatment. The 5-year event-free survival (EFS) was 58.9% ± 1.7% for B-cell ALL and 47.4% ± 5.9% for T-cell ALL, while the 5-year overall survival (OS) was 67.5% ± 1.6% for B-cell ALL and 54.3% ± 0.6% for T-cell ALL. The 5-year cumulative incidence of central nervous system (CNS) relapse was 5.5% ± 0.6%. For the whole cohort, significantly higher outcomes were seen for patients aged 1–10 years, with DNA index &gt;0.9, with hyperdiploid ALL, and without substantial treatment modifications. In multivariable analyses, age and Day 15 MRD continued to have a significant effect on EFS.ConclusionOutcomes in this multi-institutional cohort describe poor outcomes, influenced by incomplete and inconsistent risk stratification, early toxic death, high on-treatment mortality, and high CNS relapse rate. Adopting comprehensive risk-stratification strategies, evidence-informed de-intensification for favorable-risk patients and optimized supportive care could improve outcomes

La interacción didáctica como objeto de investigación del ejercicio docente en la formación de expertos en la educación superior abierta y a distancia

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La comunicación espectral en el cuidado de enfermería y los riesgos de la virtualidad.

The communication process in nursing care plays a key role in caring for people entrusted by society to professionals in this discipline. The crisiscaused by the COVID 19 pandemic has highlighted the serious situation of nurse-person communication because it has not only become complex but frankly spectral, in other words, communication is permeated by a strong bodily presence, paradoxically disembodied, which provides guidelines for discussing identity. (Sánchez Martínez). The spectral is not a static concept, because as technology advances, the frequency ranges used in communications increase (or decrease).Today human survival is threatened globally and the new communication strategies show that it is not a simple action since the identity and image of the nurse herself by incorporating virtuality as an alternative way of caring is also threatened, as well as the identity dependent on corporeality is diluted and threatened. Due to the COVID19 pandemic, face-to-face interpersonal communication is compromised, as well as the confidentiality of information, privacy and security. The public and the private have lost their limits crossed by virtuality, which is the technological phenomenon of digital as a new way of relating, both in time and space and provides experiences that are perhaps only possible in that dimension. However, there is also a distorted image of the subject, the setting of care and the role of health service providers. Due to the COVID19 pandemic, the public and the private have requested their limits crossed by the virtuality that is the technological phenomenon of digital as a way of relating, both in time and space, and provides experiences that are perhaps only possible in that dimension for which there is a distorted image of the subject, the setting of care and the role of health service providers.El proceso de comunicación en el cuidado de enfermería ocupa un papel primordial en la atención de las personas confiadas por la sociedad a los profesionales de esta disciplina. La crisis suscitada por la pandemia de COVID 19 ha puesto en evidencia la grave situación de la comunicación enfermera-persona porque no solo se ha tornado compleja sino francamente espectral es decir que la comunicación está permeada por una fuerte presencia corporal paradójicamente sin cuerpo, lo cual da pauta para discutir la identidad. (Sánchez Martínez). Lo espectral no es un concepto estático, pues a medida que avanza la tecnología aumentan (o disminuyen) rangos de frecuencia utilizados en comunicaciones. Hoy la supervivencia humana se encuentra amenazada de manera global y las nuevas estrategias de comunicación ponen de manifiesto que no se trata de una simple acción ya que se ve amenazada la identidad y la imagen de la propia enfermera al incorporar la virtualidad como forma alternativa de cuidar. La identidad dependiente de la corporalidad se ve diluida y amenazada. Por la pandemia COVID-19 está comprometida la comunicación interpersonal cara a cara, así mismo la confidencialidad de la información, la privacidad y la seguridad. Lo público y lo privado han pedido sus límites atravesados por la virtualidad que es el fenómeno tecnológico de lo digital como una forma de relacionarse, tanto en el tiempo como en el espacio y brinda experiencias que tal vez solo son posibles en esa dimensión por lo cual existe una imagen distorsionada del sujeto, del escenario de la atención y del papel de los prestadores de servicios de salud

Experimental and Theoretical Studies on Acid Corrosion Inhibition of API 5L X70 Steel with Novel 1-N-&alpha;-d-Glucopyranosyl-1H-1,2,3-Triazole Xanthines

A series of novel 1-N-&alpha;-d-glucopyranosyl-1H-1,2,3-triazole xanthines was synthesized from azido sugars (glucose, galactose, and lactose) and propargyl xanthines (theophylline and theobromine) using a typical copper (I)-catalyzed azide&ndash;alkyne 1,3-dipolar cycloaddition. The corrosion inhibition activities of these new carbohydrate-xanthine compounds were evaluated by studying the corrosion of API 5 L X70 steel in a 1 M HCl medium. The results showed that, at 10 ppm, a 90% inhibition efficiency was reached by electrochemical impedance spectroscopy. The inhibitory efficiency of these molecules is explained by means of quantum chemical calculations of the protonated species with the solvent effect, which seems to better represent the actual situation of the experimental conditions. Some quantum chemical parameters were analyzed to characterize the inhibition performance of the tested molecules