Percepción del ambiente educacional en dos escuelas de medicina con currículo tradicional. Estudio longitudinal;

Background: To establish an educational environment that ensures the quality of the teaching-learning process is a challenge for any educational institution. The questionnaire DREEM (Dundee Ready Educational Environment Measure) is used to identify strengths and weaknesses of an educational environment and to compare different medical schools. Aim: To evaluate the changes in the perception of educational environment by students of the Schools of Medicine of the University of Zaragoza, UZar (Spain) and the University of Chile, UCh (Chile) at two points in their curricula. Material and Methods: DREEM questionnaire was answered by 90 students from the UZar and 87 students of the UCh, when they were in the first year (2009) and in the fourth year of their career (2012). Results: At both universities the overall mean scores of DREAM were significantly higher in students in their first year than those obtained in the fourth year (137.5/118.3 for UZar and 128.6/118.8 for UCh). Items with worse perception in the fourth year were observed in subscales Learning Perception and Atmosphere Perception. Items with good evaluation (= 3.0) were the subscales Perception of teachers, academic self-perception, perception of Environment and Social Self-perception. Conclusions: The perception of Chilean and Spanish students about their educational environments indicates that the stage of their medical training is more important than the geographical context or educational institution

Analysis of genome expression of rhizobium etli in free living and plant-associated symbiotic state

Comunicaciones a congreso

Interpretable clinical time-series modeling with intelligent feature selection for early prediction of antimicrobial multidrug resistance

Electronic health records provide rich, heterogeneous data about the evolution of the patients’ health status. However, such data need to be processed carefully, with the aim of extracting meaningful information for clinical decision support. In this paper, we leverage interpretable (deep) learning and signal processing tools to deal with multivariate time-series data collected from the Intensive Care Unit (ICU) of the University Hospital of Fuenlabrada (Madrid, Spain). The presence of antimicrobial multidrug-resistant (AMR) bacteria is one of the greatest threats to the health system in general and to the ICUs in particular due to the critical health status of the patients therein. Thus, early identification of bacteria at the ICU and early prediction of their antibiotic resistance are key for the patients’ prognosis. While intelligent data-based processing and learning schemes can contribute to this early prediction, their acceptance and deployment in the ICUs require the automatic schemes to be not only accurate but also understandable by clinicians. Accordingly, we have designed trustworthy intelligent models for the early prediction of AMR based on the combination of meaningful feature selection with interpretable recurrent neural networks. These models were created using irregularly sampled clinical measurements, both considering the health status of the patient and the global ICU environment. We explored several strategies to cope with strongly imbalance data, since only a few ICU patients are infected by AMR bacteria. It is worth noting that our approach exhibits a good balance between performance and interpretability, especially when considering the difficulty of the classification task at hand. A multitude of factors are involved in the emergence of AMR (several of them not fully understood), and the records only contain a subset of them. In addition, the limited number of patients, the imbalance between classes, and the irregularity of the data render the problem harder to solve. Our models are also enriched with SHAP post-hoc interpretability and validated by clinicians who considered model understandability and trustworthiness of paramount concern for pragmatic purposes. Moreover, we use linguistic fuzzy systems to provide clinicians with explanations in natural language. Such explanations are automatically generated from a pool of interpretable rules that describe the interaction among the most relevant features identified by SHAP. Notice that clinicians were especially satisfied with new insights provided by our models. Such insights helped them to trust the automatic schemes and use them to make (better) decisions to mitigate AMR spreading in the ICU. All in all, this work paves the way towards more comprehensible time-series analysis in the context of early AMR prediction in ICUs and reduces the time of detection of infectious diseases, opening the door to better hospital care.This work is supported by the Spanish NSF grants PID2019-106623RB-C41 (BigTheory), PID2019-105032GB-I00 (SPGraph), PID2019-107768RA-I00 (AAVis-BMR), RTI2018-099646-B-I00 (ADHERE-U); the Galician Ministry of Education, University and Professional Training grants ED431F 2018/02 (eXplica-IA) and ED431G2019/04; the Instituto de Salud Carlos III, Spain grant DTS17/00158; as well as the Community of Madrid in the framework of the Multiannual Agreement with Rey Juan Carlos University in line of action 1, “Encouragement of Young Phd students investigation” Project Ref. F661 (Mapping-UCI). Sergio M. Aguero is a recipient of the Predoctoral Contracts for Trainees URJC Grant (PREDOC21-036). Jose M. Alonso-Moral is a Ramon Cajal Researcher (RYC-2016-19802).S

Consultoría integral en una empresa fabricante de autopartes y reparadora de motores de inyección diésel en el municipio de Guadalajara, Jalisco

ITESO, A.C

Protein Array Profiling of Tic Patient Sera Reveals a Broad Range and Enhanced Immune Response against Group A Streptococcus Antigens

The human pathogen Group A Streptococcus (Streptococcus pyogenes, GAS) is widely recognized as a major cause of common pharyngitis as well as of severe invasive diseases and non-suppurative sequelae associated with the existence of GAS antigens eliciting host autoantibodies. It has been proposed that a subset of paediatric disorders characterized by tics and obsessive-compulsive symptoms would exacerbate in association with relapses of GAS-associated pharyngitis. This hypothesis is however still controversial. In the attempt to shed light on the contribution of GAS infections to the onset of neuropsychiatric or behavioral disorders affecting as many as 3% of children and adolescents, we tested the antibody response of tic patient sera to a representative panel of GAS antigens. In particular, 102 recombinant proteins were spotted on nitrocellulose-coated glass slides and probed against 61 sera collected from young patients with typical tic neuropsychiatric symptoms but with no overt GAS infection. Sera from 35 children with neither tic disorder nor overt GAS infection were also analyzed. The protein recognition patterns of these two sera groups were compared with those obtained using 239 sera from children with GAS-associated pharyngitis. This comparative analysis identified 25 antigens recognized by sera of the three patient groups and 21 antigens recognized by tic and pharyngitis sera, but poorly or not recognized by sera from children without tic. Interestingly, these antigens appeared to be, in quantitative terms, more immunogenic in tic than in pharyngitis patients. Additionally, a third group of antigens appeared to be preferentially and specifically recognized by tic sera. These findings provide the first evidence that tic patient sera exhibit immunological profiles typical of individuals who elicited a broad, specific and strong immune response against GAS. This may be relevant in the context of one of the hypothesis proposing that GAS antigen-dependent induction of autoantibodies in susceptible individuals may be involved the occurrence of tic disorders

Use of High-Flow Cannula in Pediatric Patients With Respiratory Failure: A Prospective Cohort Study in Three High-Altitude Hospitals

BACKGROUND AND AIMS: Acute respiratory failure (ARF) is a common cause of morbimortality, and a frequent reason for admission to the pediatric intensive care unit (PICU). It requires a high-flow oxygen device as treatment. Our aim is to determine the frequency and main indications for the use of high-flow nasal cannula (HFNC), and the prevalence of HFNC failure and its main causes, in three hospitals. METHODS: It is a multicenter prospective cohort study, developed in three hospitals in Bogota. Eligible patients were children older than 1 month and younger than 18 years who presented ARF and required management with an HFNC. The study was carried out between April 2020 and December 2021. The follow-up was carried out at 1, 6, and 48 h after starting the management. RESULTS: Of 685 patients included in the study, 296 developed ARF. The prevalence of patients with ARF who required management with HFNC was 48%. The frequency of the pathologies that cause the ARF was: Bronchiolitis was the most frequent pathology (34.5%), followed by asthmatic crisis (15.5%) and pneumonia (12.7%). The average time of use of HFNC was 81.6 h. Regarding treatment failure with HFNC, 15 patients presented torpid evolution and required invasive mechanical ventilation, with a prevalence of therapeutic failure of the HFNC of 10.6%. CONCLUSION: The use of HFNC is more frequent in patients with bronchiolitis, in children under 2 years of age and in males, which is in line with what has been reported in the literature. In addition, the failure rate of HFNC is low (10.6%), and it may be useful in other pathologies besides bronchiolitis, such as asthma, pneumonia, among others. It opens the possibility to continue evaluating the role of HFNC in pediatric pathology in new studies

Use of High-Flow Cannula in Pediatric Patients with Respiratory Failure: A Prospective Cohort Study in Three High-Altitude Hospitals

BACKGROUND AND AIMS: Acute respiratory failure (ARF) is a common cause of morbimortality, and a frequent reason for admission to the pediatric intensive care unit (PICU). It requires a high-flow oxygen device as treatment. Our aim is to determine the frequency and main indications for the use of high-flow nasal cannula (HFNC), and the prevalence of HFNC failure and its main causes, in three hospitals. METHODS: It is a multicenter prospective cohort study, developed in three hospitals in Bogota. Eligible patients were children older than 1 month and younger than 18 years who presented ARF and required management with an HFNC. The study was carried out between April 2020 and December 2021. The follow-up was carried out at 1, 6, and 48 h after starting the management. RESULTS: Of 685 patients included in the study, 296 developed ARF. The prevalence of patients with ARF who required management with HFNC was 48%. The frequency of the pathologies that cause the ARF was: Bronchiolitis was the most frequent pathology (34.5%), followed by asthmatic crisis (15.5%) and pneumonia (12.7%). The average time of use of HFNC was 81.6 h. Regarding treatment failure with HFNC, 15 patients presented torpid evolution and required invasive mechanical ventilation, with a prevalence of therapeutic failure of the HFNC of 10.6%. CONCLUSION: The use of HFNC is more frequent in patients with bronchiolitis, in children under 2 years of age and in males, which is in line with what has been reported in the literature. In addition, the failure rate of HFNC is low (10.6%), and it may be useful in other pathologies besides bronchiolitis, such as asthma, pneumonia, among others. It opens the possibility to continue evaluating the role of HFNC in pediatric pathology in new studies

Comparison of Chemical Composition, Physicochemical Parameters, and Antioxidant and Antibacterial Activity of the Essential Oil of Cultivated and Wild Mexican Oregano Poliomintha longiflora Gray

Mexican oregano Poliomintha longiflora Gray located in the municipality of Higueras, Nuevo Leon, Mexico was collected during the autumn (September, OCO), winter (January, OCI) and summer (June, OCV) seasons, under cultivation conditions. It was also collected in wild conditions during the autumn (OSO). Essential oil (EO) was extracted from leaves and the color, refractive index and density were reported. The EO yield, antioxidant activity by ORAC assay, thymol and carvacrol concentration and antibacterial activity were statistically compared (p-value = 0.05). Among the various harvests, the highest EO yield, antioxidant activity, thymol and carvacrol content and antibacterial activity against Salmonella Typhi were observed in leaves harvested in autumn. In order to compare wild oregano with cultivated oregano, analyses were performed in the season with the highest essential oil yield and antioxidant activity, recorded in autumn. The main difference found was the ratio of thymol:carvacrol in wild oregano oil, which was 1:8.6, while in cultivated oregano, it was approximately 1:2, which was maintained in all three seasons. The EO on wild conditions showed the best antibacterial activity in Salmonella Typhi. On the other hand, wild and cultivated oregano showed similar antioxidant activity. One advantage of the use of cultivated oregano is that its supply is guaranteed, in contrast to that of wild oregano

Synthetic Conjugates of Ursodeoxycholic Acid Inhibit Cystogenesis in Experimental Models of Polycystic Liver Disease

Background and Aims Polycystic liver diseases (PLDs) are genetic disorders characterized by progressive development of symptomatic biliary cysts. Current surgical and pharmacological approaches are ineffective, and liver transplantation represents the only curative option. Ursodeoxycholic acid (UDCA) and histone deacetylase 6 inhibitors (HDAC6is) have arisen as promising therapeutic strategies, but with partial benefits. Approach and Results Here, we tested an approach based on the design, synthesis, and validation of a family of UDCA synthetic conjugates with selective HDAC6i capacity (UDCA-HDAC6i). Four UDCA-HDAC6i conjugates presented selective HDAC6i activity, UDCA-HDAC6i #1 being the most promising candidate. UDCA orientation within the UDCA-HDAC6i structure was determinant for HDAC6i activity and selectivity. Treatment of polycystic rats with UDCA-HDAC6i #1 reduced their hepatomegaly and cystogenesis, increased UDCA concentration, and inhibited HDAC6 activity in liver. In cystic cholangiocytes UDCA-HDAC6i #1 restored primary cilium length and exhibited potent antiproliferative activity. UDCA-HDAC6i #1 was actively transported into cells through BA and organic cation transporters. Conclusions These UDCA-HDAC6i conjugates open a therapeutic avenue for PLDs.Supported by the Spanish Carlos III Health Institute (ISCIII; J.M. Banales: FIS PI15/01132, PI18/01075 and Miguel Servet Program CON14/00129; M.J. Perugorria: PI14/00399, PI17/00022; J.J.G. Marin: FIS PI16/00598) cofinanced by "Fondo Europeo de Desarrollo Regional" (FEDER); CIBERehd (ISCIII): J.M. Banales, M.J. Perugorria, L. Bujanda, and J.J.G. Marin; Spanish Ministry of Economy and Competitiveness (M. J. Perugorria: Ramon y Cajal Program RYC-2015-17755); IKERBASQUE, Basque foundation for Science (M.J. Perugorria and J.M. Banales), Spain; "Junta de Castilla y Leon" (J.J.G. Marin: SA06P17); " Diputacion Foral Gipuzkoa" (J.M. Banales: DFG15/010, DFG16/004; M.J. Perugorria: DFG18/114, DFG19/081), BIOEF (Basque Foundation for Innovation and Health Research: EiTB Maratoia BIO15/CA/016/BD to J.M. Banales), Department of Health of the Basque Country (J.M. Banales: 2017111010; M.J. Perugorria: 2019111024), and Euskadi RIS3 (J.M. Banales: 2016222001, 2017222014, and 2018222029; 2019222054); La Caixa Scientific Foundation (J.M. Banales: HR17-00601); "Fundacion Cientifica de la Asociacion Espanola Contra el Cancer" (AECC Scientific Foundation, to J.M. Banales and J.J.G. Marin); and "Centro Internacional sobre el Envejecimiento", Spain (J.J.G. Marin: OLD-HEPAMARKER, 0348-CIE-6-E). F.J. Caballero-Camino was funded by the Spanish Ministry of Science and Innovation (BES-2014-069148), A. Santos-Laso by the Basque Government (PRE_2018_2_0195), and Pui Y. Lee-Law by the European Association for the Study of the Liver (EASL; Sheila Sherlock Award). The Spanish Ministry of Science and Innovation supported F. P. Cossio: (CTQ2016-80375-P and CTQ2014-51912-REDC) as well as the Basque Government (F.P. Cossio: IT-324-07). I. Rivilla had a postdoctoral contract from the Donostia International Physics Center