Lung Transplantation in Controlled Donation after Circulatory-Determination-of-Death Using Normothermic Abdominal Perfusion

The main limitation to increased rates of lung transplantation (LT) continues to be the availability of suitable donors. At present, the largest source of lung allografts is still donation after the neurologic determination of death (brain-death donors, DBD). However, only 20% of these donors provide acceptable lung allografts for transplantation. One of the proposed strategies to increase the lung donor pool is the use of donors after circulatory-determination-of-death (DCD), which has the potential to significantly alleviate the shortage of transplantable lungs. According to the Maastricht classification, there are five types of DCD donors. The first two categories are uncontrolled DCD donors (uDCD); the other three are controlled DCD donors (cDCD). Clinical experience with uncontrolled DCD donors is scarce and remains limited to small case series. Controlled DCD donation, meanwhile, is the most accepted type of DCD donation for lungs. Although the DCD donor pool has significantly increased, it is still underutilized worldwide. To achieve a high retrieval rate, experience with DCD donation, adequate management of the potential DCD donor at the intensive care unit (ICU), and expertise in combined organ procurement are critical. This review presents a concise update of lung donation after circulatory-determination-of-death and includes a step-by-step protocol of lung procurement using abdominal normothermic regional perfusion

Optimism and resilience among university students

University life is full of stressful stimuli that can contribute to psychological distress and lower performance levels. Despite academic demands, university students also face new stressors, such as different social networks, financial changes, and adaptation to new family and social roles that may have a negative impact on their mental health (Pidgeon y Pickett, 2017). In this sense, resilience literature has gained acceptance explaining how some students successfully adapt to university life while others find great challenges. Since resilience has been defined as the ability to successfully adapt in the face of stress and adversity, it is important to determine what psychological factors contribute enhancing this resilience levels. One of the factors related to life adaptation is optimism, understood as the general expectancy of obtaining positive outcomes in the future (Scheier y Carver, 1985). Hence, the aim of this study is to study the relationship between optimism and resilience among a sample of university students in Spain.The sample was comprised of 132 students from the University of Cádiz (Spain). Participants were selected by quota sampling from first to last year of studies. The majority of students (72.5%) were female and average age was 21.71 (range = 18–48, SD = 3.75). Participants completed the Wagnild and Young Resilience Scale (Spanish version adapted by Novella, 2002) and Life Orientation Test (LOT-R Spanish version adapted by Ferrando, Chico y Tous).We performed hierarchical multiple regression analysis and obtained that optimism explained 25% of resilience among university students (R2 = .25, â = .49). No gender and age differences were observed. Thus, identifying the factors that influence students’ adjustment to university life can improve the targeting of interventions to improve university academic performance. Moreover, this research could contribute helping students to successfully face this life transition, increasing their well-being and life satisfaction levels and decreasing university absenteeism

Programa emocional en alumnado de segundo de e.s.o. con déficit en sus logros académicos

Emotional management is considered one of the emerging challenges in current society. In this sense, the educational field appears as one of the pioneers designing and implementing of programs to promote its development, favoring in the students’ social and personal skills (Guil and Gil-Olarte, 2007). According to current educational laws in Spain, educational administrations should promote the maximum personal, intellectual, social, and emotional development of students (Organic Educational Law 2/2006, of May 3, modified by the Organic Law 9/2013, of 9 December, for the Improvement of Educational Quality). However, in Middle School (in Spain Secondary Mandatory School, ESO) we find few programs that address this integral development. Moreover, these students have special educational needs in order to achieve academic performance due, among others, to emotional competencies and social skills deficits (Santamaría and Valdés, 2017). Specifically, in Andalusia, students of Basic Vocational Training, usually present high rates of absenteeism, as well as poor motivation, self-concept, self-esteem, and social skills (Junta de Andalucía, 2018). To respond to this situation, we propose a pilot project aimed to increase academic achievement and socio-academic adaptation through emotional competencies. This project has been developed with five students from eighth grade (second year of Spanish ESO) that met the basic criteria to begin Basic Vocational Training next academic year. In this way, students’ emotional competencies will be developed through the reinforcement of instrumental and fundamental curricular subjects, complementary to formal education.La gestión emocional se plantea como uno de los retos emergentes en la sociedad actual. Eneste sentido, el ámbito educativo se presenta como uno de los pioneros en el diseño e implementación de programas que promueven su desarrollo, favoreciendo en el alumnado sus competencias sociales y personales (Guil y Gil-Olarte, 2007). De acuerdo con la normativa educativa vigente, las administraciones educativas promoverán el máximo desarrollo personal, intelectual, social y emocional del alumnado (Ley Orgánica 2/2006, de 3 de mayo, de Educación modificada por la Ley Orgánica 9/2013, de 9 de diciembre, para la Mejora de la Calidad Educativa). Sin embargo, en la Educación Secundaria Obligatoria (E.S.O.) encontramos escasos programas que atiendan a este desarrollo integral. Asimismo, este alumnado presenta necesidades específicas de apoyo educativo para alcanzar el logro académico debido, entre otras  razones, a su déficit en diversas competencias emocionales y habilidades sociales (Santamaría y Valdés, 2017). Concretamente, en Andalucía, el alumnado de Formación Profesional Básica presenta altas tasas de absentismo, así como escasa motivación, autoconcepto, autoestima y habilidades sociales, entre otras características (Junta de Andalucía, 2018). Para dar respuesta a esta situación, planteamos un proyecto piloto cuya finalidad será incrementar el logro académico y la adaptación socioescolar a través de las competencias emocionales. Dicho proyecto se ha llevado a cabo con cinco alumnos/as de segundo curso de E.S.O. que cumplen las características necesarias para iniciar las enseñanzas de Formación Profesional Básica en el próximo curso escolar. De este modo, se desarrollarán las competencias emocionales del alumnado con el refuerzo de las materias instrumentales y fundamentales del currículum de manera complementaria a la enseñanza formal

Diseño del Sistema de Gestión de Seguridad y Salud en el Trabajo para la empresa Miguel Caballero dando cumplimiento al decreto 1072 de 2015

El diseño del Sistema de Gestión de la Seguridad y Salud en el Trabajo para la empresa Miguel Caballero cobra importancia, al dar cumplimiento a la reglamentación obligatoria para todas las empresas legalmente constituidas en Colombia. Este proyecto permitirá identificar los riesgos y probabilidades que tienen los trabajadores de experimentar un accidente o enfermedad laboral derivado de sus actividades y funciones, y así lograr comunicarlas a la gerencia y al trabajador para poder tomar medidas que permitan mitigar o eliminar dichos riesgos de acuerdo con la raíz del peligro.Tabla de Contenidos iv Capítulo 1 Introducción e información general 1 Planteamiento del problema 1 Objetivos de la investigación 4 Objetivo general 4 Objetivos específicos 4 Capítulo 2 Justificación 5 Delimitación del contexto 6 Capítulo 3 Marcos referenciales 8 Estado del arte 8 Marco teórico 16 Marco Legal 25 Hipótesis 32 Capítulo 4 Marco Metodológico 33 Paradigma 33 Tipo de investigación 33 Diseño de investigación 34 Población y Muestra 34 Instrumentos y técnica de análisis de instrumentos 35 Fases de la investigación 39 Cronograma 41 Presupuesto 43 Capítulo 5 Resultados y conclusiones 44 Resultados 44 Análisis de resultados 52 Conclusiones 75 Lista de referenciasEspecializaciónEspecialista en Gerencia de la Seguridad y Salud en el TrabajoEspecialización en Gerencia de la Seguridad y Salud en el Trabaj

A chromosome-level genome assembly enables the identification of the follicule stimulating hormone receptor as the master sex-determining gene in the flatfish Solea senegalensis

Sex determination (SD) shows huge variation among fish and a high evolutionary rate, as illustrated by the Pleuronectiformes (flatfishes). This order is characterized by its adaptation to demersal life, compact genomes and diversity of SD mechanisms. Here, we assembled the Solea senegalensis genome, a flatfish of great commercial value, into 82 contigs (614 Mb) combining long- and short-read sequencing, which were next scaffolded using a highly dense genetic map (28,838 markers, 21 linkage groups), representing 98.9% of the assembly. Further, we established the correspondence between the assembly and the 21 chromosomes by using BAC-FISH. Whole genome resequencing of six males and six females enabled the identification of 41 single nucleotide polymorphism variants in the follicle stimulating hormone receptor (fshr) consistent with an XX/XY SD system. The observed sex association was validated in a broader independent sample, providing a novel molecular sexing tool. The fshr gene displayed differential expression between male and female gonads from 86 days post-fertilization, when the gonad is still an undifferentiated primordium, concomitant with the activation of amh and cyp19a1a, testis and ovary marker genes, respectively, in males and females. The Y-linked fshr allele, which included 24 nonsynonymous variants and showed a highly divergent 3D protein structure, was overexpressed in males compared to the X-linked allele at all stages of gonadal differentiation. We hypothesize a mechanism hampering the action of the follicle stimulating hormone driving the undifferentiated gonad toward testisEuropean Union's Horizon 2020 research and innovation programme under grant agreement (AQUA-FAANG). Grant Number: 81792. Junta de Andalucía-FEDER Grant. Grant Number: P20-00938. Spanish Ministry of Economy and Competitiveness, FEDER Grants. Grant Numbers: RTI2018-096847-B-C21, RTI2018-096847-B-C22S

Jardins per a la salut

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia. Assignatura: Botànica farmacèutica. Curs: 2014-2015. Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són el recull de les fitxes botàniques de 128 espècies presents en el Jardí Ferran Soldevila de l’Edifici Històric de la UB. Els treballs han estat realitzats manera individual per part dels estudiants dels grups M-3 i T-1 de l’assignatura Botànica Farmacèutica durant els mesos de febrer a maig del curs 2014-15 com a resultat final del Projecte d’Innovació Docent «Jardins per a la salut: aprenentatge servei a Botànica farmacèutica» (codi 2014PID-UB/054). Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pels professors de l’assignatura. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica. També s’ha pretès motivar els estudiants a través del retorn de part del seu esforç a la societat a través d’una experiència d’Aprenentatge-Servei, deixant disponible finalment el treball dels estudiants per a poder ser consultable a través d’una Web pública amb la possibilitat de poder-ho fer in-situ en el propi jardí mitjançant codis QR amb un smartphone

COVID-19 outbreaks in a transmission control scenario: challenges posed by social and leisure activities, and for workers in vulnerable conditions, Spain, early summer 2020

Severe acute respiratory syndrome coronavirus 2 community-wide transmission declined in Spain by early May 2020, being replaced by outbreaks and sporadic cases. From mid-June to 2 August, excluding single household outbreaks, 673 outbreaks were notified nationally, 551 active (>6,200 cases) at the time. More than half of these outbreaks and cases coincided with: (i) social (family/friends’ gatherings or leisure venues) and (ii) occupational (mainly involving workers in vulnerable conditions) settings. Control measures were accordingly applied

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

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three genomic nomenclature systems to all sequence data from the World Health Organization European Region available until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation, compare the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2

Manual de simulación clínica en especialidades médicas

Manual sobre técnicas y modos de simulación clínica en diversas especialidades médicas.La enseñanza y formación en medicina necesita el uso de la simulación. Existen evidencias de su uso desde hace cientos de años, pero, en los últimos años se ha incrementado y diseminado. La simulación clínica está validada científicamente en múltiples contextos médicos y de otras áreas profesionales de la salud. Y es considerada de gran importancia como proceso de entrenamiento y de mejora de las competencias y adquisición de habilidades médicas en campos que incluye desde la historia clínica, comunicación con el paciente, exploración, diagnóstico terapéutica médica-farmacológica y quirúrgica y seguridad al tratar al paciente. Hoy en día, para muchas técnicas y situaciones clínicas es inaceptable llegar junto a los pacientes sin un dominio adquirido en simulación. La simulación puede ocurrir sin el uso de recursos adicionales, solo las personas, o utilizando pocos o muchos recursos de baja hasta alta tecnología y se puede adaptar a los recursos disponibles, abarcando todas las áreas de conocimiento, y dentro de ellas competencias técnicas o actitudes, solas o en conjunto. El uso racional y basado en evidencia de la simulación es de la mayor importancia por la necesidad de una mayor efectividad y eficiencia en la transformación de los profesionales de la salud para que puedan mejorar su capacidad de atender a los pacientes. La simulación es también una buena herramienta de evaluación de competencias y habilidades en Medicina y otras disciplinas de las Ciencias de la Salud Este manual incluye técnicas y modos de simulación clínica en diversas especialidades médicas, útiles, para quien busque un manual práctico y actualizado.Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Terapias Avanzadas en Patología Cardiovascular Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Investigación Biomédica Quirón Salu