Cómo mejorar los resultados de los repetidores. Intervención específica en una asignatura inicial de programación

Las asignaturas de programación tienen un elevado número de estudiantes repetidores que lo intentan una segunda, tercera o incluso más veces. Son estudiantes que normalmente se ven obligados a hacer actividades similares a las que no supieron o no pudieron hacer en los intentos anteriores. Este artículo presenta el diseño y experiencia de una intervención específica para este colectivo de estudiantes basado en los resultados de un análisis previo sobre su comportamiento. En dicha intervención se ha reforzado el acompañamiento del profesor para mejorar el apoyo ofrecido a los estudiantes repetidores, pero no ha resultado suficiente. En consecuencia, se propone una futura línea de investigación consistente en un diseño más completo y específico que permita aprovechar el trabajo y los logros previos de cada estudiante repetidor.Programming courses have a high number of students who are compelled to repeat a second, third or even more times. They are students who are usually forced to do activities very similar to those they did not know or could not do in previous attempts and without taking advantage of the work already done. This article presents the design of a specific intervention for this group of students based on the results of a previous analysis. Such an intervention reinforces the accompaniment of the teacher in order to improve the support offered to the repeating students. However, this reinforcement has not been enough, so a more complete and specific design is proposed as a future line that allows us to take advantage of the previous achievements of each repeating student.Investigación del grupo LAIKA Learning Analytics for Innovation and Knowledge Application in Higher Education parcialmente financiada por el proyecto 2017SGR1619 de la Generalitat de Catalunya

Metformin-Associated Acute Kidney Injury and Lactic Acidosis

Objectives. Metformin is the preferred oral antidiabetic agent for type 2 diabetes. Lactic acidosis is described as a rare complication, usually during an acute kidney injury (AKI). Material and Methods. We conducted a prospective observational study of metformin-associated AKI cases during four years. 29 cases were identified. Previous renal function, clinical data, and outcomes were recorded. Results. An episode of acute gastroenteritis precipitated the event in 26 cases. Three developed a septic shock. Three patients died, the only related factor being liver dysfunction. More severe metabolic acidosis hyperkalemia and anemia were associated with higher probabilities of RRT requirement. We could not find any relationship between previous renal dysfunction and the outcome of the AKI. Conclusions. AKI associated to an episode of volume depletion due to gastrointestinal losses is a serious complication in type 2 diabetic patients on metformin. Previous renal dysfunction (mild-to-moderate CKD) has no influence on the severity or outcome

¿Por qué los estudiantes de una asignatura inicial de programación se convierten en repetidores?

Learning to program is hard for many students. As a result, CS1 courses have a significant percentage of repeaters. For this reason, the goal of this article is to analyze what factors affect repeaters so that a specific learning strategy for them can be performed. In this regard, a first analysis of a CS1 course shows there are two types of repeaters: (1) those who do (almost) nothing throughout the semester and drop out, and (2) those who work during the whole semester, but finally fail. According to repeaters’ perceptions, they were motivated to learn to program, but it was difficult for them to keep up because of it was so hard to reconcile it with their personal context, so based on what they did the previous semester, they would prefer to continue from where they left off or change the pace of activitie

¿Quién tropieza dos veces con la misma piedra en una asignatura inicial de programación?

Aprender a programar no es sencillo y es sabido que un porcentaje elevado de estudiantes fracasa en su primer intento. De hecho, en asignaturas introductorias de programación hay muchos estudiantes repetidores. La experiencia de “Fundamentos de Programación” muestra que hay dos tipos de estudiantes repetidores: los que no hacen nada o casi nada y abandonan, y los que lo intentan, pero suspenden. En este trabajo presentamos un análisis de los resultados de los estudiantes repetidores en esta asignatura y su participación en las actividades propuestas, con la finalidad de diseñar una intervención que les ofrezca un itinerario formativo adaptado a su situación y necesidades, y que tenga en cuenta sus logros previos. Basándonos en la literatura y el análisis realizado, identificamos los factores que explican el fracaso de los estudiantes en su primer intento.Learning to code is not easy and a high percentage of students fail on their first attempt. In fact, in introductory programming courses there are many students who are repeating the course. The experience of “Programming Foundations” shows that there are two types of students repeating the course: those who do nothing or almost nothing and drop out, and those who try but fail. In this paper we present an analysis of the results of the repeating students repeating and their participation in the proposed activities, with the ultimate objective of designing an intervention that provides them with a learning itinerary adapted to their situation and needs, taking into account their previous achievements. Based on the literature and the analysis carried out, we enumerate the factors that explain students’ failure in their first attempt

Dalbavancin as suppressive antibiotic therapy in patients with prosthetic infections: efficacy and safety

Suppressive antibiotic therapy (SAT) is a strategy to alleviate symptoms and/or to reduce the progression of an infection when other treatment options cannot be used. Dalbavancin, due to its prolonged half-life, enables (bi) weekly dosing. Here, we report our multicenter real-life clinical experience with dalbavancin used as SAT in patients with prosthetic joint or vascular infections. Medical records of all adult patients with documented vascular or orthopedic chronic prosthetic infections, who received dalbavancin as SAT between 2016 and 2018 from four Spanish hospitals were reviewed for inclusion. Descriptive analysis of demographic characteristics, Charlson Comorbidity index, Barthel index, isolated pathogens and indication, concomitant antibiotic use, adverse events, and clinical outcome of SAT were performed. Eight patients were eligible for inclusion, where six patients had prosthetic vascular infections (aortic valve) and two patients had knee prosthetic joint infections. The most common pathogens were methicillin-susceptible Staphylococcus aureus and Enterococcus faecium. All patients had a history of prior antibiotic treatment for the prosthetic infection [median duration of antibiotic days 125 days (IQR, 28–203 days)]. The median number of dalbavancin doses was 29 (IQR, 9–61) and concomitant antibiotic use (n = 5, 62.5%). Clinical success was reported in 75% (n = 6) of patients. Adverse events were reported in two patients (mild renal and hepatic impairment). The median estimated cost savings due to the avoided hospital days was €60185 (IQR, 19,916–94984) per patient. Despite the limitations of our study, this preliminary data provides valuable insight to support further evaluation of dalbavancin for SAT in patients with prosthetic infections in the outpatient setting when alternative treatments are not feasible

Social network analysis as a tool to inform sustainable multi-sectoral management in complex marine socioecosystems

In complex marine socioecosystems, where multiple sectoral activities coexist, management can be especially complicated. This is the case of the coupled Guadalquivir estuary - Gulf of Cadiz (Ge-GoC) system. The Guadalquivir estuary (SW Spain) plays a central role in the whole Gulf of Cadiz since many fish species use these waters as a nursery area. Therefore, not only fisheries management is important but also the environmental status of the estuarine waters. The latter will have an effect on the adult populations via recruitment. Human activities that directly or indirectly influence the estuary include fishing, agriculture, shipping, saltworks, tourism or aquaculture among others. Conflict among them are common. In this context, we have used social network analyses as a first step to create an analysis and decision-support framework to achieve balanced socio-ecological ecosystem based management (EBM) to the Ge-GOC

Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective Spanish cohort study

[Background] To assess the impact of blood cultures negative infective endocarditis (BCNIE) on in-hospital mortality.[Methods] Prospective multicentre study with retrospective analysis of a Spanish cohort including adult patients with definite IE. Cardiac implantable devices infection were excluded. Comparisons between blood cultures positive and BCNIE groups were performed to analyse in-hospital mortality.[Results] 1001 cases were included of which 83 (8.3%) had BCNIE. Alternative microbiological diagnosis was achieved for 39 (47%) out 83 cases. The most frequent identifications were: Coxiella burnetii (11; 28.2%), Tropheryma whipplei (4; 10.3%), Streptococcus gallolyticus (4;10.3%) and Staphylococcus epidermidis (3; 7.7%). Surgery was performed more frequently in BCNIE group (57.8 vs. 36.9%, p < .001). All-cause in-hospital mortality rate was 26.7% without statistical difference between compared groups. BCNIE was not associated to worse mortality rate in Cox regression model (aHR = 1.37, 95% CI 0.90–2.07, p = .14). Absence of microbiological diagnosis was also not associated to worse in-hospital prognosis (aHR = 1.62, 95% CI 0.99–2.64, p = .06).[Conclusions] In our cohort, BCNIE was not associated to greater in-hospital mortality based in multivariate Cox regression models. The variables most frequently associated with mortality were indicated but not performed surgery (aHR = 2.48, 95% CI 1.73–3.56, p < .001), septic shock (aHR = 2.24, 95% CI 1.68–2.99, p < .001), age over 65 years (aHR = 1.88, 95% CI 1.40-2.52, p < .001) and complicated endocarditis (aHR = 1.79, 95% CI 1.36–2.37, p < .001).Peer reviewe

Infective endocarditis in patients with heart transplantation

[Background] The incidence of nosocomial and health care-related infective endocarditis (IE) is increasing. Heart transplantation (HT) implies immunosuppression and frequent health care contact. Our aim was to describe the current profile and prognosis of IE in HT recipients.[Methods] Multicenter retrospective registry-based study in Spain and France that included cases between 2008 and 2019.[Results] During the study period, 8305 HT were performed in Spain and France. We identified 18 IE cases (rate 0.2%). Median age was 57 years; 12 were men (67%). Valve involvement did not have a predominant location and three patients (16.7%) had atrial or ventricular vegetations without valve involvement. The median age-adjusted Charlson index was 4 (interquartile range 3–5). Eleven IE cases (61%) were nosocomial/health care-related. Median time (range) between HT and development of IE was 43 months (interquartile range 6–104). The major pathogens were Staphylococcus sp. (n = 8, 44%), Enterococcus sp. (n = 4, 22%), and Aspergillus sp. (n = 3, 17%). Although eight patients (44%) had a surgical indication, it was only performed in three cases (17%). Three patients (17%) died during the first IE hospital admission.[Conclusions] IE in HT recipients has specific characteristics. Valve involvement does not have a predominant location and non-valvular involvement is common. Three fifths have a nosocomial/health care-related origin. The major pathogens were staphylococci (44%), enterococci (22%), and Aspergillus (17%). In-hospital mortality was 17%.Peer reviewe

Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT

Cardiovascular Infectious Study Group of the Andalusian Society of Infectious Diseases.Ampicillin plus ceftriaxone (AC) is a well-recognized inpatient regimen for Enterococcus faecalis infective endocarditis (IE). In this regimen, ceftriaxone is usually administered 2 g every 2 h (AC12). The administration of AC in outpatient parenteral antibiotic treatment (OPAT) programs is challenging because multiple daily doses are required. AC regimens useful for OPAT programs include once-daily high-dose administration of ceftriaxone (AC24) or AC co-diluted and jointly administered in bolus every 4 h (ACjoined). In this retrospective analysis of prospectively collected cases, we aimed to assess the clinical effectivity and safety of three AC regimens for the treatment of E. faecalis IE. Fifty-nine patients were treated with AC combinations (AC12 n = 32, AC24 n = 17, and ACjoined n = 10). Six relapses occurred in the whole cohort: five (29.4%) treated with AC24 regimen and one (10.0%) with ACjoined. Patients were cured in 30 (93.3%), 16 (94.1%), and eight (80.0%) cases in the AC12, AC24 and ACjoined groups, respectively. Unplanned readmission occurred in eight (25.0%), six (35.3%), and two (20.0%) patients in the AC12, AC24 and ACjoined groups, respectively. The outcome of patients with E. faecalis IE treated with AC in OPAT programs relies on an optimization of the delivery of the combination. AC24 exhibit an unexpected rate of failures, however, ACjoined might be an effective alternative which clinical results should corroborate in further studies.The authors received no financial support for the research, authorship, and/or publication of this article. GVA was supported by the Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Miguel Servet (grant CP19/00159). HHL was supported by the Instituto de Salud Carlos III, Subprograma Rio Hortega (grant CM19/00152)

Resultados clínicos iniciales y variables pronósticas en la implementación de un Código Sepsis en un Hospital Universitario de alta complejidad

Objective: To assess the impact of the first months of application of a Code Sepsis in a high complexity hospital, analyzing patient´s epidemiological and clinical characteristics and prognostic factors. Methods: A long-term observational study was carried out throughout a consecutive period of seven months (February 2015 - September 2015). The relationship with mortality of risk factors, and analytic values was analyzed using uni- and multivariate analyses. Results: A total of 237 patients were included. The in-hospital mortality was 24% at 30 days and 27% at 60 days. The mortality of patients admitted to Critical Care Units was 30%. Significant differences were found between the patients who died and those who survived in mean levels of creatinine (2.30 vs 1.46 mg/dL, p 65 years (OR 5.33, p 3 mmol/L (OR 5,85, p 1,2 mgr /dL (OR 4,54, p <0,05) and shock (OR 6,57, P <0,05). Conclusions: The epidemiological, clinical and mortality characteristics of the patients in our series are similar to the best published in the literature. The study has identified several markers that could be useful at a local level to estimate risk of death in septic patients. Studies like this one are necessary to make improvements in the Code Sepsis programsObjetivo. Evaluar el impacto de un programa educativo y organizativo llamado Código Sepsis, en los primeros siete meses de su aplicación en un hospital de alta complejidad. Material y métodos. Se realizó un estudio observacional durante un período consecutivo de siete meses (Febrero 2015-Septiembre 2015). Se analizó la relación con la mortalidad de los factores de riesgo y los valores analíticos usando análisis uni y multivariante. Resultados. Se incluyeron un total de 237 pacientes. La mortalidad intrahospitalaria a los 30 días fue del 24 % y del 27% a los 60 días. La mortalidad de los pacientes ingresados en Unidades de Cuidados Críticos fue del 30%. Se encontraron diferencias significativas entre los pacientes que murieron y los que sobrevivieron en sus valores medios de creatinina (2,30 vs 1,46 mg/dL, p <0,05), ácido láctico (6,10 vs 2,62 mmol/L, p <0,05) y procalcitonina (23,27 vs 12,73 mg/dL, p <0,05). Se encontró una tendencia lineal estadísticamente significativa entre los valores de la escala SOFA y la mortalidad (p <0,05). En el análisis multivariante se identificaron otros factores de riesgo independientes asociados con la muerte: edad > 65 años (OR 5,33, p 3 mmol/L (OR 5,85, p <0,05), creatinina > 1,2 mgr/dL (OR 4,54, p <0,05) y el shock (OR 6,57, P <0,05). Conclusiones. La mortalidad en este estudio se encuentra dentro de los límites de los ensayos clínicos más recientes de sepsis. El estudio ha identificado varios marcadores que podrían ser útiles a nivel local para estimar el riesgo en pacientes sépticos. Estudios como éste son necesarios para hacer mejoras en los programas de Código Sepsi