Análisis del uso de distintos recursos en una web didáctica

To analyze how students use online learning tools, such as didactic websites, a common practice is to report global access statistics. Although these are adequate measures, they are not specific enough and do not allow to determine if there are differences depending on the type of resources available to students. The aim of this study is to compare how students use different types of resources in a didactic website, distinguishing between resources to be evaluated in a final exam, resources for work in the classroom, extension resources not to be evaluated, and online extension resources. To this end, the 96 students (87 women, 9 men) taking part in the research enrolled in a subject that is part of the Degree in Speech Therapy, and where a didactic website was used as a tool to complement face-to-face teaching. The total number of accesses to the didactic website and the average number of reads of each type of resources were taken as units of measure. The results indicated that, although the number of visits generally reflected an intense, frequent, stable use of the website, at the same time there were some types of resources that were hardly used by students. Thus, it is suggested that the availability of a particular learning resource on a didactic website does not imply that it will be used, and that the best way to increase the use of a resource is to evaluate it, or to use it in the classroom.A la hora de analizar el uso que los estudiantes hacen de las herramientas docentes on-line, como es el caso de las webs didácticas, frecuentemente se recurre a las estadísticas globales de acceso. Si bien son medidas adecuadas, resultan poco específicas y no permiten conocer si hay diferencias en función de los tipos de recursos que el alumno tiene disponibles. El objetivo de este trabajo fue comparar el uso que los alumnos hacen de distintos tipos de recursos en una web didáctica, distinguiendo entre recursos evaluados en el examen final, recursos para el trabajo en el aula, recursos de ampliación no evaluados y recursos on-line de ampliación. Participaron 96 estudiantes (87 mujeres, 9 hombres) matriculados en una asignatura perteneciente al Grado en Logopedia y en la que se utilizó una web didáctica como herramienta para complementar la docencia presencial. Como medidas, se tomaron el número total de accesos a la web didáctica y el promedio de consultas a cada tipo de tipo de recursos. Los resultados mostraron que, si bien a nivel global hubo un uso intenso, frecuente y estable de la web, al mismo tiempo hubo algunos recursos que apenas fueron consultados por los alumnos. Por tanto, se sugiere que la disponibilidad de un recurso de aprendizaje determinado en una web didáctica no supone que vaya a ser utilizado y que la forma de aumentar el uso de un recurso es evaluándolo o utilizándolo directamente en el aula

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

Genetic landscape of 6089 inherited retinal dystrophies affected cases in Spain and their therapeutic and extended epidemiological implications

Inherited retinal diseases (IRDs), defined by dysfunction or progressive loss of photoreceptors, are disorders characterized by elevated heterogeneity, both at the clinical and genetic levels. Our main goal was to address the genetic landscape of IRD in the largest cohort of Spanish patients reported to date. A retrospective hospital-based cross-sectional study was carried out on 6089 IRD affected individuals (from 4403 unrelated families), referred for genetic testing from all the Spanish autonomous communities. Clinical, demographic and familiar data were collected from each patient, including family pedigree, age of appearance of visual symptoms, presence of any systemic findings and geographical origin. Genetic studies were performed to the 3951 families with available DNA using different molecular techniques. Overall, 53.2% (2100/3951) of the studied families were genetically characterized, and 1549 different likely causative variants in 142 genes were identified. The most common phenotype encountered is retinitis pigmentosa (RP) (55.6% of families, 2447/4403). The most recurrently mutated genes were PRPH2, ABCA4 and RS1 in autosomal dominant (AD), autosomal recessive (AR) and X-linked (XL) NON-RP cases, respectively; RHO, USH2A and RPGR in AD, AR and XL for non-syndromic RP; and USH2A and MYO7A in syndromic IRD. Pathogenic variants c.3386G > T (p.Arg1129Leu) in ABCA4 and c.2276G > T (p.Cys759Phe) in USH2A were the most frequent variants identified. Our study provides the general landscape for IRD in Spain, reporting the largest cohort ever presented. Our results have important implications for genetic diagnosis, counselling and new therapeutic strategies to both the Spanish population and other related populations.This work was supported by the Instituto de Salud Carlos III (ISCIII) of the Spanish Ministry of Health (FIS; PI16/00425 and PI19/00321), Centro de Investigación Biomédica en Red Enfermedades Raras (CIBERER, 06/07/0036), IIS-FJD BioBank (PT13/0010/0012), Comunidad de Madrid (CAM, RAREGenomics Project, B2017/BMD-3721), European Regional Development Fund (FEDER), the Organización Nacional de Ciegos Españoles (ONCE), Fundación Ramón Areces, Fundación Conchita Rábago and the University Chair UAM-IIS-FJD of Genomic Medicine. Irene Perea-Romero is supported by a PhD fellowship from the predoctoral Program from ISCIII (FI17/00192). Ionut F. Iancu is supported by a grant from the Comunidad de Madrid (CAM, PEJ-2017-AI/BMD7256). Marta del Pozo-Valero is supported by a PhD grant from the Fundación Conchita Rábago. Berta Almoguera is supported by a Juan Rodes program from ISCIII (JR17/00020). Pablo Minguez is supported by a Miguel Servet program from ISCIII (CP16/00116). Marta Corton is supported by a Miguel Servet program from ISCIII (CPII17/00006). The funders played no role in study design, data collection, data analysis, manuscript preparation and/or publication decisions

Revisión sobre las relaciones entre percepción y acción en la infancia

Convergences and divergences in theories that have been a referent in the study of the relations between perception and action, like Piaget’s and Gibson’s, are discussed. From this traditional view, ulterior interpretations are considered, especially the ones related to the neurological basis of visual perceptual and action pathways and approaches that question the functional independence of both processes putting emphasis on the dynamic relation between both of them.Se discuten las convergencias y divergencias de las teorías que han sido un referente para el estudio de las relaciones entre la percepción y la acción, tales como las de Piaget y Gibson. A partir de esta visión tradicional se profundiza sobre las interpretaciones posteriores relacionadas con las bases neurológicas de las trayectorias visuales de la percepción y de la acción y sobre las aportaciones que cuestionan la independencia funcional de estos procesos, destacando la importancia de una comunicación dinámica entre ellos

A review on perception-action relations in infancy

Se discuten las convergencias y divergencias de las teorías que han sido un referente para el estudio de las relaciones entre la percepción y la acción, tales como las de Piaget y Gibson. A partir de esta visión tradicional se profundiza sobre las interpretaciones posteriores relacionadas con las bases neurológicas de las trayectorias visuales de la percepción y de la acción y sobre las aportaciones que cuestionan la independencia funcional de estos procesos, destacando la importancia de una comunicación dinámica entre ellos

Revista de logopedia, foniatría y audiología

Resumen basado en el de la publicaciónDurante el desarrollo del lenguaje, algunos niños encuentran dificultades para articular fonemas o grupos consonánticos, sin que haya una causa neurológica ni orgánica aparente. El tratamiento de estas dificultades ha comprendido técnicas diversas, otorgando poca importancia a las praxias fonoarticulatorias, que consisten en la realización de movimientos programados y organizados de forma intencional y coordinada dirigidos a controlar los músculos faciales y los órganos activos de la articulación, como son lengua, labios y paladar blando. Ante la falta de conocimiento sobre la relevancia de estas praxias para la prevención y tratamiento de las dificultades articulatorias en los trastornos de los sonidos del habla, se plantea como objetivo aplicar un programa de intervención en una muestra de niños de cuatro años con problemas articulatorios. Para ello, se evaluó a un grupo de 25 niños de 4.6 años de media de edad. De ellos, quince no tenían adquiridos todos los fonemas, de modo que fueron distribuidos en un grupo de tratamiento (ocho niños) y un grupo de control (siete niños). Los niños del grupo de tratamiento se sometieron a un programa de intervención de dos sesiones semanales de 30-45min cada una durante un periodo de tres meses. Finalizado el tratamiento, los quince niños fueron evaluados de nuevo y se hizo un seguimiento diez meses después. Los resultados muestran una tendencia a la mejora en el grupo de tratamiento que además se mantiene en los diez meses posteriores, y esto es especialmente significativo para los niños con alteraciones más graves, es decir, más de siete fonemas sin producir.Biblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

Differences in macular vessel density in the superficial plexus across cognitive impairment : the NORFACE cohort

Optical coherence tomography angiography (OCT-A) allows the detection of retinal vessel density (VD) loss, which is a reflection of brain vascular pathology. We aimed to investigate differences in macular VD in the superficial plexus in a large cohort of individuals cognitively unimpaired (CU), with mild cognitive impairment due to Alzheimer's disease (MCI-AD), MCI due to cerebrovascular pathology (MCI-Va), probable Alzheimer's disease dementia (ADD) and Vascular Dementia (VaD). Clinical, demographical, ophthalmological and OCT-A data from the Neuro-ophthalmology Research at Fundació ACE (NORFACE) project were analyzed. Differences of macular VD in four quadrants (superior, nasal, inferior and temporal) among the five diagnostic groups were assessed in a multivariate regression model, adjusted by age, sex, education, hypertension, diabetes mellitus, heart disease and stroke. The study cohort comprised 672 participants: 128 CU, 120 MCI-AD, 111 MCI-Va, 257 ADD and 56 VaD. Regression analysis showed a significantly higher VD in the temporal quadrant in MCI-AD compared to CU participants (49.05 ± 4.91 vs 47.27 ± 4.17, p = 0.02, d = 0.40), and a significantly lower VD in the inferior quadrant in MCI-Va compared to CU participants (48.70 ± 6.57 vs 51.27 ± 6.39, p = 0.02, d = 0.40). Individuals with heart disease presented significantly lower VD in the inferior quadrant than those without (p = 0.01). The interaction of sex and diagnosis had no effect in differentiating VD. Mini-Mental State Examination (MMSE) scores were not correlated to VD (all r 0.07). In conclusion, our study showed that the MCI-AD and MCI-Va groups had significant differences in macular VD in opposite directions in the temporal and inferior quadrants, respectively, compared to CU participants, suggesting that macular VD might be able to differentiate two pathogenic pathways (AD- and cerebrovascular-related) in early stages of cognitive decline

The Synergic Effect of AT(N) Profiles and Depression on the Risk of Conversion to Dementia in Patients with Mild Cognitive Impairment

Few studies have addressed the impact of the association between Alzheimer’s disease (AD) biomarkers and NPSs in the conversion to dementia in patients with mild cognitive impairment (MCI), and no studies have been conducted on the interaction effect of these two risk factors. AT(N) profiles were created using AD-core biomarkers quantified in cerebrospinal fluid (CSF) (normal, brain amyloidosis, suspected non-Alzheimer pathology (SNAP) and prodromal AD). NPSs were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). A total of 500 individuals with MCI were followed-up yearly in a memory unit. Cox regression analysis was used to determine risk of conversion, considering additive and multiplicative interactions between AT(N) profile and NPSs on the conversion to dementia. A total of 224 participants (44.8%) converted to dementia during the 2-year follow-up study. Pathologic AT(N) groups (brain amyloidosis, prodromal AD and SNAP) and the presence of depression and apathy were associated with a higher risk of conversion to dementia. The additive combination of the AT(N) profile with depression exacerbates the risk of conversion to dementia. A synergic effect of prodromal AD profile with depressive symptoms is evidenced, identifying the most exposed individuals to conversion among MCI patients

Macular vessel density in the superficial plexus is not associated to cerebrospinal fluid core biomarkers for Alzheimer's disease in individuals with mild cognitive impairment : The NORFACE cohort

Optical coherence tomography angiography (OCT-A) is a novel method in the dementia field that allows the detection of retinal vascular changes. The comparison of OCT-A measures with established Alzheimer's disease (AD)-related biomarkers is essential to validate the former as a marker of cerebrovascular impairment in the AD continuum. We aimed to investigate the association of macular vessel density (VD) in the superficial plexus quantified by OCT-A with the AT(N) classification based on cerebrospinal fluid (CSF) Aβ1-42, p181-tau and t-tau measurements in individuals with mild cognitive impairment (MCI). Clinical, demographic, ophthalmological, OCT-A and CSF core biomarkers for AD data from the Neuro-ophthalmology Research at Fundació ACE (NORFACE) project were analyzed. Differences in macular VD in four quadrants (superior, nasal, inferior, and temporal) among three AT(N) groups [Normal, Alzheimer and Suspected non-Alzheimer pathology (SNAP)] were assessed in a multivariate regression model, adjusted for age, APOE ε4 status, hypertension, diabetes mellitus, dyslipidemia, heart disease, chronic obstructive pulmonary disease and smoking habit, using the Normal AT(N) group as the reference category. The study cohort comprised 144 MCI participants: 66 Normal AT(N), 45 Alzheimer AT(N) and 33 SNAP AT(N). Regression analysis showed no significant association of the AT(N) groups with any of the regional macular VD measures (all, p > 0.16). The interaction between sex and AT(N) groups had no effect on differentiating VD. Lastly, CSF Aβ1-42, p181-tau and t-tau measures were not correlated to VD (all r 0.13). Our study showed that macular VD measures were not associated with the AT(N) classification based on CSF biomarkers in patients with MCI, and did not differ between AD and other underlying causes of cognitive decline in our cohort