Chapter Distribution Diagrams and Graphical Methods to Determine or to Use the Stoichiometric Coefficients of Acid-Base and Complexation Reactions

Computer networking & communication

Using gamification in a teaching innovation project at the University of Alcala: a new approach to experimental science practices

Pre-service teachers frequently express negative prejudices towards science and the methodologies traditionally used during their training. Gamification is a booming technology based on combining the psychological aspects, mechanics and dynamics of a game in non-ludic environments. The use of gamification has shown good outcomes in terms of increasing students´ motivation towards the sciences. In this study, new laboratory practices were developed under the umbrella of gamification methodology for pre-service teachers. The general objectives were to eliminate negative prejudices, fear and rejection attitudes towards science, to foster the conceptual and procedural learning of science among students and to provide students with real-life examples and an experience of applying gamification themselves. First, the theoretical basis of the main components and dynamics of gamification in the Education context are summarized. Secondly, their application in a specific subject from the curriculum for the Teaching Training in Primary Education degree (Didactics of Natural Science (DNS), 3rd year) are presented. The methodology was applied twice in laboratory practice in two consecutive academic years: 2017/2018 (5 groups, 150 students ) and 2018/2019 (6 groups, 183 students) . The steps, dynamics, components and the tools used for the gamification experience are described (i.e. Kahoot, Class Dojo). Several pre and post-tests were carried out to explore: (i) the students' relationship with games; (ii) their preferred role as players; (iii) their assessment of the different elements involved in the gamification methodology; (iv) their motivation towards science laboratories attitude and (v) their self-perception with regards to their newly acquired skills to put gamification into practice in their professional future.Universidad de Alcal

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

RIE : revista de investigación educativa

Resumen basado en el de la publicaciónTítulo, resumen y palabras clave en español e inglésSe destacan los aspectos clave para una implementación exitosa del aula invertida y se incluyen objetivos didáctico-disciplinares imprescindibles para el aprendizaje significativo de las Ciencias Experimentales. El estudio se ha realizado en el contexto de la asignatura de Ciencias de la Materia y la Energía en tres titulaciones vinculadas al Grado en Magisterio de Educación Primaria y abarca más de 200 estudiantes, tanto en el grupo experimental como en el grupo control. Se ha abordado a través de tres instrumentos: el rendimiento académico de las distintas partes de la asignatura; grupos de discusión del personal docente implicado; y cuestionario final cumplimentado por el alumnado. El análisis de los mismos evidencia una mejora significativa en los resultados académicos de forma mayoritaria, al igual que un cambio favorable en sus expectativas como futuros docentes de Ciencias y en el desarrollo de actitudes positivas hacia las Ciencias. Además, se analizan los beneficios logrados durante el proceso de enseñanza-aprendizaje, tales como el desarrollo de la capacidad de metacognición, el cambio de roles del personal docente y el alumnado y una mayor retroalimentación y nivel cognitivo alcanzados. Por último, se discuten estos resultados en base a dichos aspectos clave del aula invertida con la inclusión de los objetivos didácticos-disciplinares propios de las Ciencias Experimentales, así como la visión del personal docente a lo largo del mismo.ES

Chapter Distribution Diagrams and Graphical Methods to Determine or to Use the Stoichiometric Coefficients of Acid-Base and Complexation Reactions

Computer networking & communication

Incidencia del abuso del alcohol en el comportamiento académico de los estudiantes del Colegio público Dr. Modesto Armijo Lozano, Sutiaba, León-León

Tesis (Lic. en Ciencias Sociales)-Universidad Nacional Autónoma de Nicaragua, LeónUNAN-Leó