Apprendre la chimie avec les orbitales OrbiMol, une boîte à outils pédagogique

International audienc

European Joint Doctorates: myth or reality?

Today, there is a lack of consensus for the full implementation of common programmes recognizing the “highest” level of higher education in Europe. Even though cotuttelle agreements are widely used for international joint supervision of PhD theses, these are merely bilateral and individual case-based agreements, far away from a real joint degree under a legal framework that establishes the programme. This article aims to describe the experience of the authors in the management and coordination of a joint doctoral programme between 2015 and 2019 and the results obtained from the interrogation of official websites about the reality in Europe concerning such programmes. Our conclusion is that, still in the 21st century, there is a huge gap to be overcome before the existence of Joint International/European Doctorates can be considered an everyday reality. Although various attempts have been made in the last 20 years, there is still a long way to go for Higher Education institutions to integrate all aspects of such programmes, and to make them something more and different than an additional Diploma Supplement. In the authors´ opinion, major efforts must be made by the administrative bodies, although the drive of the academic staff is crucial for success.  [ES] Today, there is a lack of consensus for the full implementation of common programmes recognizing the “highest” level of higher education in Europe. Even though cotuttelle agreements are widely used for international joint supervision of PhD theses, these are merely bilateral and individual case-based agreements, far away from a real joint degree under a legal framework that establishes the programme. This article aims to describe the experience of the authors in the management and coordination of a joint doctoral programme between 2015 and 2019 and the results obtained from the interrogation of official websites about the reality in Europe concerning such programmes. Our conclusion is that, still in the 21st century, there is a huge gap to be overcome before the existence of Joint International/European Doctorates can be considered an everyday reality. Although various attempts have been made in the last 20 years, there is still a long way to go for Higher Education institutions to integrate all aspects of such programmes, and to make them something more and different than an additional Diploma Supplement. In the authors´ opinion, major efforts must be made by the administrative bodies, although the drive of the academic staff is crucial for success.Coy Fuster, P.; Canovas, S.; Van Soom, A.; Bernabo, N.; Lonergan, P.; Schellander, K. (2020). European Joint Doctorates: myth or reality?. En 6th International Conference on Higher Education Advances (HEAd'20). Editorial Universitat Politècnica de València. (30-05-2020):1109-1117. https://doi.org/10.4995/HEAd20.2020.11209OCS1109111730-05-202

Metformin's Role in Hyperlactatemia and Lactic Acidosis in ICU Patients: A Systematic Review.

INTRODUCTION Metformin-treated patients may experience severe hyperlactatemia or lactic acidosis (LA). LA often requires intensive-care-unit (ICU) treatment, and mortality rates are high. Here, we investigate the impact of renal dysfunction and renal replacement therapy (RRT) on the outcomes of critically ill patients with metformin-associated LA (MALA). Furthermore, we assessed associations between mortality and metformin dose, metformin plasma/serum concentrations, lactate level, and arterial pH. Finally, we investigated whether the recommended classification in MALA, metformin-unrelated LA, metformin-induced LA, and LA in metformin therapy appears useful in this regard. METHODS We performed a retrospective analysis based on a systematic PubMed search for publications on hyperlactatemia/LA in metformin-treated ICU patients from January 1995 to February 2020. Case-level data including demographics and clinical conditions were extracted, and logistic regression analyses were performed. RESULTS A total of 92 ICU patients were reported. Two of these patients had no comorbidities interfering with lactate metabolism. In the overall group, arterial pH, lactate levels, and metformin plasma/serum concentrations were similar in survivors versus non-survivors. Ingested daily metformin doses and plasma/serum creatinine levels were significantly higher in survivors versus non-survivors (p = 0.007 vs. p = 0.024, respectively). Higher plasma/serum creatinine levels, higher lactate levels, and lower arterial pH were all associated with patients receiving RRT (all p < 0.05). Overall mortality was 22% (20 out of 92 patients) and did not differ between the RRT and non-RRT groups. CONCLUSION Mortality is high in ICU patients with metformin-associated hyperlactatemia/LA. Unexpectedly, higher ingested metformin dose and plasma/serum creatinine were associated with a better outcome. Survival was similar in patients with or without need for RRT

Estudio de prefactibilidad para la instalación de una planta productora de bizcochos a base de harina de kiwicha (Amaranthus caudatus) con semillas de chía (Salvia hispanica)

En el presente trabajo, realizamos un estudio de pre-factibilidad para instalar una fábrica productora de bizcochos a base de harina de kiwicha con semillas de chía, con el objetivo de precisar si el proyecto es viable económica, social, ambiental, comercial y técnicamente al establecer dicha fábrica. El mercado objetivo está determinado por los hombres y mujeres de Lima Metropolitana entre los NSE A, B y C, que se preocupen por tener una vida saludable. Además, se calculó que la demanda anual máxima y tamaño de planta del proyecto es de 2 064 948 paquetes de bizkiwicha de 70 g cada uno, que equivalen a 172 079 cajas de 12 bizcochos. Se estableció que la localización óptima de la fábrica es Lurín, en el parque industrial Lúcumo. También se determinó que el tamaño de planta estará limitado por el tamaño de mercado. Se verificó que se requerirán cuatro operarios por cada turno de trabajo, se armó el plan de producción anual, el requerimiento de materiales y el plano de la industria con un área total de 999,23 ¿2. Concluimos que el proyecto cuenta con rentabilidad y viabilidad positivas. Esto obteniendo, luego de la evaluación económica, un VAN de 147 838 soles y un TIR de 22,59% mayor al COK de 18,00%. Asimismo, obtuvimos un VAN de 223 134 soles y un TIR de 33,10% mayor al CPPC de 12,80%. Se midió la contribución social del proyecto de inversión, lo que se calculó obteniendo los siguientes resultados: el cálculo del valor agregado en 4 268 304 soles, densidad de capital 70 250 soles/habitante, intensidad de capital de 0,2633 soles invertidos por cada sol de valor agregado, y la relación producto-capital de 3,80 veces la inversión.In the present work, a prefactibility study was carried out for the installation of a plant that produces cakes based on amaranth flour with chia seeds, with the aim of determining the economic, social, environmental, market and technical viability of the installation of said plant. The target market is determined by men and women of Metropolitan Lima between SEL A, B and C, who have a healthy diet. In addition, the annual demand for the project was calculated, which is 2 064 948 packages of bizkiwicha 70g each, equivalent to 172 079 boxes of 12 cakes. It was established that the optimal location for the plant is Lurin, in the Lucumo industrial park. Also, we determined that the plant size will be limited by the market size. It was verified that four operators will be required each turn, the annual production plan was elaborated, the material requirement calculated, and the industry construction plan designed with a total area of 999,23 m2. We concluded that the project has both positive profitability and viability. After the economic evaluation, we obtained a NPV of 147 838 soles and an IRR of 22,59%, which is higher than the COK of 18,00%. In addition, we obtained a NPV of 223 134 soles and an IRR of 33,10%, which is higher than the CPPC of 12,80%. The social contribution of the investment project was measured, which was calculated, obtaining the following results: the calculation of the added value in 4 268 304 soles, capital density 70 250 soles / inhabitant, Capital intensity of 0,2633 of investment for each sol of added value, and the product-capital ratio of 3,80 times the investment

Compliance With Guideline-Directed Medical Therapy in Contemporary Coronary Revascularization Trials

Background: Despite the well-established benefits of secondary cardiovascular prevention, the importance of concurrent medical therapy in clinical trials of coronary revascularization is often overlooked. Objectives: The goal of this study was to assess compliance with guideline-directed medical therapy (GDMT) in clinical trials and its potential impact on the comparison between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Methods: The Cochrane Central Register of Controlled Trials and MEDLINE were searched from 2005 to August 2017. Clinical trial registries and reference lists of relevant studies were also searched. Randomized controlled trials comparing PCI with drug-eluting stents versus CABG and reporting medical therapy after revascularization were included. The study outcome was compliance with GDMT, defined as the following: 1) any antiplatelet agent plus beta-blocker plus statin (GDMT1); and 2) any antiplatelet agent plus beta-blocker plus statin plus angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (GDMT2). Data collection and analysis were performed according to the methodological recommendations of The Cochrane Collaboration. Results: From a total of 439 references, 5 trials were included based on our inclusion and exclusion criteria. Overall, compliance with GDMT1 was low and decreased over time from 67% at 1 year to 53% at 5 years. Compliance with GDMT2 was even lower and decreased from 40% at 1 year to 38% at 5 years. Compliance with both GDMT1 and GDMT2 was higher in PCI than in CABG at all time points. Meta-regression suggested an association between lower use of GDMT1 and adverse clinical outcomes in PCI versus CABG at 5 years. Conclusions: Compliance with GDMT in contemporary clinical trials remains suboptimal and is significantly lower after CABG than after PCI, which may influence the comparison of clinical trial endpoints between those study groups

An intermediate-effect size variant in UMOD confers risk for chronic kidney disease

The kidney-specific gene UMOD encodes for uromodulin, the most abundant protein excreted in normal urine. Rare large-effect variants in UMOD cause autosomal dominant tubulointerstitial kidney disease (ADTKD), while common low-impact variants strongly associate with kidney function and the risk of chronic kidney disease (CKD) in the general population. It is unknown whether intermediate-effect variants in UMOD contribute to CKD. Here, candidate intermediate-effect UMOD variants were identified using large-population and ADTKD cohorts. Biological and phenotypical effects were investigated using cell models, in silico simulations, patient samples, and international databases and biobanks. Eight UMOD missense variants reported in ADTKD are present in the Genome Aggregation Database (gnomAD), with minor allele frequency (MAF) ranging from 10(−5) to 10(−3). Among them, the missense variant p.Thr62Pro is detected in ∼1/1,000 individuals of European ancestry, shows incomplete penetrance but a high genetic load in familial clusters of CKD, and is associated with kidney failure in the 100,000 Genomes Project (odds ratio [OR] = 3.99 [1.84 to 8.98]) and the UK Biobank (OR = 4.12 [1.32 to 12.85). Compared with canonical ADTKD mutations, the p.Thr62Pro carriers displayed reduced disease severity, with slower progression of CKD and an intermediate reduction of urinary uromodulin levels, in line with an intermediate trafficking defect in vitro and modest induction of endoplasmic reticulum (ER) stress. Identification of an intermediate-effect UMOD variant completes the spectrum of UMOD-associated kidney diseases and provides insights into the mechanisms of ADTKD and the genetic architecture of CKD