Aplicación de la clase invertida en la asignatura Biología Celular e Histología

La clase invertida o clase al revés, también conocida por el anglicismo flipped classroom, es una metodología docente en la que, como su nombre indica, se invierten los procesos que clásicamente tienen lugar dentro y fuera del aula. De manera que se pasa de una clase centrada en el profesor, como transmisor de la información y con un alumno receptor pasivo de la información cuyo trabajo fuera del aula consiste en la realización de tareas, a un modelo en el que el alumno, debe recibir y asimilar la información que le es facilitada previamente a la clase. En el aula, los alumnos resuelven dudas y realizan tareas, en muchos casos en equipo, de manera que el trabajo en el aula pasa a estar centrado en el alumno, que debe ser responsable de su propio aprendizaje. Los profesores que ya aplican esta metodología en distintos niveles educativos, se muestran muy satisfechos con el aumento del rendimiento de los estudiantes, la gran aceptación que tiene esta metodología, el aumento del aprendizaje significativo, es decir, la capacidad de relacionar los conocimientos previos con los nuevos y ser capaces de aplicar lo aprendido para la resolución de problemas. La asignatura “Biología Celular e Histología” del Grado en Biología se imparte con carácter anual durante el primer curso del grado, con una carga docente de 12 ECTS. Cada año se matriculan en la asignatura más de 400 alumnos, 300 en primera matrícula. Los contenidos teóricos que deben adquirir los alumnos son extensos y complejos, lo que supone una notable carga de trabajo para los alumnos que, si se limitan a una mera asistencia pasiva a clase, no son capaces de obtener un aprovechamiento óptimo de los contenidos y por tanto obtener buenos resultados. Además de esos contenidos teóricos, los alumnos deben adquirir unos contenidos prácticos mediante 5 sesiones de laboratorio de Biología Celular y 9 sesiones de laboratorio de Histología. Existen varios profesores implicados en la docencia teórica de esta asignatura, ya que los alumnos matriculados se dividen en 6 grupos y en algunos casos, la docencia se divide entre dos profesores, uno encargado de la parte de Biología Celular y otro de la parte de Histología. Cada profesor tiene su propio perfil docente, pero todos basamos nuestras clases en una metodología tradicional de clase magistral, es decir, una docencia centrada en el profesor, como foco transmisor de información que el alumno debe asimilar. Todos utilizamos el Campus Virtual donde colocamos las presentaciones que utilizamos en clase y donde organizamos las sesiones de seminarios. En general, año tras año, los profesores de esta asignatura observamos una falta de implicación de los alumnos en su propio aprendizaje, de manera que reciben la información de manera pasiva, escuchando al profesor, en muchos casos sin ni siquiera tomar apuntes. Esta pasividad y escasa implicación del alumnado conlleva unos resultados reflejados en las calificaciones globales generalmente decepcionantes, y que a nuestro juicio son susceptibles de mejora aumentando la motivación del alumnado mediante nuevas metodologías docentes. Con este proyecto de innovación docente, hemos elaborado el material necesario para aplicar el método “flipped learning” o clase invertida en un bloque de temas de Biología Celular y en otro bloque de temas de Histología. Este tipo de metodología centrada en el alumno, permite que el estudiante procese y maneje la información suministrada de forma autónoma, antes de acudir a clase, a su ritmo, de manera que el tiempo de clase puede usarse de otras maneras, por ejemplo, para solucionar dudas, discutir a fondo los aspectos más complicados del tema, o para realizar tareas de aplicación de los conocimientos previamente aprendidos en casa. De esta manera se puede lograr un aprendizaje significativo alejado de la mera memorización de los contenidos expuestos, y en donde el alumno se sienta protagonista de su propio avance y capacitación teórica de la asignatura

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A synthetic RNA-based biosensor for fructose-1,6-bisphosphate that reports glycolytic flux

RNA-based sensors for intracellular metabolites are a promising solution to the emerging issue of metabolic heterogeneity. However, their development, i.e., the conversion of an aptamer into an in vivo-functional intracellular metabolite sensor, still harbors challenges. Here, we accomplished this for the glycolytic fluxsignaling metabolite, fructose-1,6-bisphosphate (FBP). Starting from in vitro selection of an aptamer, we constructed device libraries with a hammerhead ribozyme as actuator. Using high-throughput screening in yeast with fluorescence-activated cell sorting (FACS), next-generation sequencing, and genetic-environmental perturbations to modulate the intracellular FBP levels, we identified a sensor that generates ratiometric fluorescent readout. An abrogated response in sensor mutants and occurrence of two sensor conformations— revealed by RNA structural probing—indicated in vivo riboswitching activity. Microscopy showed that the sensor can differentiate cells with different glycolytic fluxes within yeast populations, opening research avenues into metabolic heterogeneity. We demonstrate the possibility to generate RNA-based sensors for intracellular metabolites for which no natural metabolite-binding RNA element exits

Promoting enterprising biologists with the subject Projects and Studies in Biology (fourth year, Degree in Biology).

Este proyecto se elabora con el objetivo principal de fomentar el emprendimiento en los estudiantes de 4º Grado de Biología para que constituyan su empresa, redacten sus proyectos y participen en la Convocatoria de Premios de Emprendimiento Universitario UCM, en la Convocatoria Preincubadora BIO y, potencialmente, en futuras licitaciones públicas. Los miembros del equipo que han participado en el proyecto están o han estado involucrados a lo largo de varios cursos en la docencia de la asignatura de “Proyectos y Estudios en Biología”. El equipo tiene un marcado carácter interdisciplinar ya que está compuesto por profesores que pertenecen a diferentes unidades docentes de todos los departamentos de la Facultad de Ciencias Biológicas, además de dos estudiantes UCM del Grado de Biología y del Máster de Ecología, egresados del curso académico anterior. La metodología seguida para la consecución de los objetivos del proyecto se ha basado en la búsqueda, la obtención, el análisis de documentos necesarios y, finalmente, la elaboración de los materiales didácticos. Los documentos ofrecidos a los estudiantes han sido consultados en torno al 60-70% por ellos en más de 5 ocasiones. La parte que más les ha ayudado, en todos los casos, es la de la estructura de los documentos, y coinciden, en todos los documentos, en la dificultad de comprensión del lenguaje empleado. Aun así, las actividades realizadas durante el desarrollo de este proyecto han permitido que se alcance el objetivo planteado, siendo conscientes de la necesidad de continuar evaluando los resultados del proyecto a largo plazo.This project is developed with the main objective of promoting entrepreneurship in 4th Grade Biology students so that they can set up their company, write their projects and participate in the UCM University Entrepreneurship Awards Call, in the Preincubadora BIO Call, and potentially, in future public bid calls. The members of the team that have participated in the project are or have been involved throughout several years in teaching the subject “Projects and Studies in Biology”. The team has a noticeable interdisciplinary nature since it is formed of professors who belong to different teaching areas from all the departments of the Faculty of Biological Sciences, in addition to two UCM students from the Biology Degree and the Ecology Master's Degree, who graduated from the previous academic year. The methodology followed to achieve the objective of the project has been based on the search, obtaining, analysis of necessary documents, and, finally, the preparation of training aid. Around 60-70% of the students have consulted the training documents on more than 5 occasions during the year. The section that has helped them the most, in all cases, is the structure of the documents, and they coincide with the difficulty of understanding the language used in all the documents. The activities carried out during the development of this project have allowed the stated objective to be achieved, being aware of the need to continue evaluating the results of the project in the long term.Depto. de Biodiversidad, Ecología y EvoluciónDepto. de Biología CelularDepto. de Genética, Fisiología y MicrobiologíaFac. de Ciencias BiológicasFALSEsubmitte

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research

Development of the CMS detector for the CERN LHC Run 3

International audienceSince the initial data taking of the CERN LHC, the CMS experiment has undergone substantial upgrades and improvements. This paper discusses the CMS detector as it is configured for the third data-taking period of the CERN LHC, Run 3, which started in 2022. The entire silicon pixel tracking detector was replaced. A new powering system for the superconducting solenoid was installed. The electronics of the hadron calorimeter was upgraded. All the muon electronic systems were upgraded, and new muon detector stations were added, including a gas electron multiplier detector. The precision proton spectrometer was upgraded. The dedicated luminosity detectors and the beam loss monitor were refurbished. Substantial improvements to the trigger, data acquisition, software, and computing systems were also implemented, including a new hybrid CPU/GPU farm for the high-level trigger