Comparing teacher and student perspectives regarding the use of L1 in EFL chilean high school classrooms

Tesis (Profesor de Inglés para la Enseñanza Básica y Media y al grado académico de Licenciado en Educación)In the Chilean context, English teachers are commanded to perform one hundred percent English classes, but unfortunately, this is not accomplished in every context; hence, this study decided to explore and compare teachers’ and students’ perspectives regarding the use of L1 in the EFL Chilean high school classroom. A quantitative instrument was applied to a total population of 510 being both teachers and students from different districts of Santiago. The results obtained in this study portrayed that both teachers and students agreed on the L1 usage under different situations, these ranging from grammar explanation lessons to managing discipline

Impaired CpG Demethylation in Common Variable Immunodeficiency Associates With B Cell Phenotype and Proliferation Rate

Common Variable Immunodeficiency (CVID) is characterized by impaired antibody production and poor terminal differentiation of the B cell compartment, yet its pathogenesis is still poorly understood. We first reported the occurrence of epigenetic alterations in CVID by high-throughput methylation analysis in CVID-discordant monozygotic twins. Data from a recent whole DNA methylome analysis throughout different stages of normal B cell differentiation allowed us to design a new experimental approach. We selected CpG sites for analysis based on two criteria: one, CpGs with potential association with the transcriptional status of relevant genes for B cell activation and differentiation; and two, CpGs that undergo significant demethylation from naive to memory B cells in healthy individuals. DNA methylation was analyzed by bisulfite pyrosequencing of specific CpG sites in sorted naive and memory B cell subsets from CVID patients and healthy donors. We observed impaired demethylation in two thirds of the selected CpGs in CVID memory B cells, in genes that govern B cell-specific processes or participate in B cell signaling. The degree of demethylation impairment associated with the extent of the memory B cell reduction. The impaired demethylation in such functionally relevant genes as AICDA in switched memory B cells correlated with a lower proliferative rate. Our new results reinforce the hypothesis of altered demethylation during B cell differentiation as a contributing pathogenic mechanism to the impairment of B cell function and maturation in CVID. In particular, deregulated epigenetic control of AICDA could play a role in the defective establishment of a post-germinal center B cell compartment in CVID

Ajustando RFR por Preditores de Discordância, “The Adjusted RFR”: Uma Metodologia Alternativa para Melhorar a Capacidade Diagnóstica de Índices Coronarianos

Background: Cutoff thresholds for the "resting full-cycle ratio" (RFR) oscillate in different series, suggesting that population characteristics may influence them. Likewise, predictors of discordance between the RFR and fractional flow reserve (FFR) have been documented. The RECOPA Study showed that diagnostic capacity is reduced in the RFR "grey zone", requiring the performance of FFR to rule out or confirm ischemia. Objectives: To determine predictors of discordance, integrate the information they provide in a clinical-physiological index, the "Adjusted RFR", and compare its agreement with the FFR. Methods: Using data from the RECOPA Study, predictors of discordance with respect to FFR were determined in the RFR "grey zone" (0.86 to 0.92) to construct an index ("Adjusted RFR") that would weigh RFR together with predictors of discordance and evaluate its agreement with FFR. Results: A total of 156 lesions were evaluated in 141 patients. Predictors of discordance were: chronic kidney disease, previous ischemic heart disease, lesions not involving the anterior descending artery, and acute coronary syndrome. Though limited, the "Adjusted RFR" improved the diagnostic capacity compared to the RFR in the "grey zone" (AUC-RFR = 0.651 versus AUC-"Adjusted RFR" = 0.749), also showing an improvement in all diagnostic indices when optimal cutoff thresholds were established (sensitivity: 59% to 68%; specificity: 62% to 75%; diagnostic accuracy: 60% to 71%; positive likelihood ratio: 1.51 to 2.34; negative likelihood ratio: 0.64 to 0.37). Conclusions: Adjusting the RFR by integrating the information provided by predictors of discordance to obtain the "Adjusted RFR" improved the diagnostic capacity in our population. Further studies are required to evaluate whether clinical-physiological indices improve the diagnostic capacity of RFR or other coronary indices.Fundamento: Os limiares de corte para a “relação do ciclo completo de repouso” (RFR) oscilam em diferentes séries, sugerindo que as características da população podem influenciá-los. Da mesma forma, foram documentados preditores de discordância entre a RFR e a reserva de fluxo fracionado (FFR). O Estudo RECOPA, mostrou que a capacidade diagnóstica está reduzida na “zona cinzenta” da RFR, tornando necessária a realização de FFR para descartar ou confirmar isquemia. Objetivos: Determinar os preditores de discordância, integrar as informações que eles fornecem em um índice clínico-fisiológico: a “RFR Ajustada”, e comparar sua concordância com o FFR. Métodos: Usando dados do Estudo RECOPA, os preditores de discordância em relação à FFR foram determinados na “zona cinzenta” da RFR (0,86 a 0,92) para construir um índice (“RFR Ajustada”) que pesaria a RFR juntamente com os preditores de discordância e avaliar sua concordância com a FFR. Resultados: Foram avaliadas 156 lesões em 141 pacientes. Os preditores de discordância foram: doença renal crônica, cardiopatia isquêmica prévia, lesões não envolvendo a artéria descendente anterior esquerda e síndrome coronariana aguda. Embora limitada, a “RFR Ajustada” melhorou a capacidade diagnóstica em comparação com a RFR na “zona cinzenta” (AUC-RFR = 0,651 versus AUC-“RFR Ajustada” = 0,749), mostrando também uma melhora em todos os índices diagnósticos quando foram estabelecidos limiares de corte otimizados (sensibilidade: 59% a 68%; especificidade: 62% a 75%; acurácia diagnóstica: 60% a 71%; razão de verossimilhança positiva: 1,51 a 2,34; razão de verossimilhança negativa: 0,64 a 0,37). Conclusões: Ajustar a RFR integrando as informações fornecidas pelos preditores de discordância para obter a “RFR Ajustada” melhorou a capacidade diagnóstica em nossa população. Mais estudos são necessários para avaliar se os índices clínico-fisiológicos melhoram a capacidade diagnóstica da RFR ou de outros índices coronarianos

Distribution and genotype-phenotype correlation of GDAP1 mutations in Spain

Mutations in the GDAP1 gene can cause Charcot-Marie-Tooth disease. These mutations are quite rare in most Western countries but not so in certain regions of Spain or other Mediterranean countries. This cross-sectional retrospective multicenter study analyzed the clinical and genetic characteristics of patients with GDAP1 mutations across Spain. 99 patients were identified, which were distributed across most of Spain, but especially in the Northwest and Mediterranean regions. The most common genotypes were p.R120W (in 81% of patients with autosomal dominant inheritance) and p.Q163X (in 73% of autosomal recessive patients). Patients with recessively inherited mutations had a more severe phenotype, and certain clinical features, like dysphonia or respiratory dysfunction, were exclusively detected in this group. Dominantly inherited mutations had prominent clinical variability regarding severity, including 29% of patients who were asymptomatic. There were minor clinical differences between patients harboring specific mutations but not when grouped according to localization or type of mutation. This is the largest clinical series to date of patients with GDAP1 mutations, and it contributes to define the genetic distribution and genotype-phenotype correlation in this rare form of CMT

Endothelial dysfunction is an early indicator of sepsis and neutrophil degranulation of septic shock in surgical patients

Producción CientíficaBackground: Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could help to stratify the severity of infection in surgical patients. Methods: Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals. Results: There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid-regional proadrenomedullin (MR-ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell-specific molecule 1, vascular cell adhesion molecule 1 and E-selectin) had stronger associations with sepsis than infection alone. MR-ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001). Conclusion: MR-ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.Instituto de Salud Carlos III (grants PI15/01959, PI15/01451 and PI16/01156

Staging Parkinson’s Disease According to the MNCD (Motor/Non-motor/Cognition/Dependency) Classification Correlates with Disease Severity and Quality of Life

Background: Recently, a novel simple classification called MNCD, based on 4 axes (Motor; Non-motor; Cognition; Dependency) and 5 stages, has been proposed to classify Parkinson's disease (PD). Objective: Our aim was to apply the MNCD classification in a cohort of PD patients for the first time and also to analyze the correlation with quality of life (QoL) and disease severity. Methods: Data from the baseline visit of PD patients recruited from 35 centers in Spain from the COPPADIS cohort from January 2016 to November 2017 were used to apply the MNCD classification. Three instruments were used to assess QoL: 1) the 39-item Parkinson's disease Questionnaire [PDQ-39]); PQ-10; the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Results: Four hundred and thirty-nine PD patients (62.05 +/- 7.84 years old; 59% males) were included. MNCD stage was: stage 1, 8.4% (N = 37); stage 2, 62% (N = 272); stage 3, 28.2% (N = 124); stage 4-5, 1.4% (N = 6). A more advanced MNCD stage was associated with a higher score on the PDQ39SI (p < 0.0001) and a lower score on the PQ-10 (p < 0.0001) and EUROHIS-QOL8 (p < 0.0001). In many other aspects of the disease, such as disease duration, levodopa equivalent daily dose, motor symptoms, non-motor symptoms, and autonomy for activities of daily living, an association between the stage and severity was observed, with data indicating a progressive worsening related to disease progression throughout the proposed stages. Conclusion: Staging PD according to the MNCD classification correlated with QoL and disease severity. The MNCD could be a proper tool to monitor the progression of PD

Objetivos ambientales de la agricultura española: recomendaciones científicas para su implementacion efectiva según la nueva política agraria común 2023-2030

[EN]: The next reform ofthe EU Common Agricultural Policy (CAP) for the period 2021-2027 (currently extended to 2023-2030) requires the approval by the European Commission of a Strategic Plan with environmental objectives for each Member State. Here we use the best available scientific evidence on the relationships between agricultural practices and biodiversity to delineate specific recommendations for the development of the Spanish Strategic Plan. Scientific evidence shows that Spain should (1) identify clear regional biodiversity targets and the landscape-level measures needed to achieve them; (2) define ambitious and complementary criteria across the three environmental instruments (enhanced conditionality, eco-schemes, and agri-environmental and climate measures) of the CAP’s Green Architecture, especially in simple and complex landscapes; (3) ensure that other CAP instruments (areas of nature constraints, organic farming and protection of endangered livestock breeds and crop varieties) really support biodiversity; (4) improve farmers’ knowledge and adjust measures to real world constraints; and (5) invest in biodiversity and ecosystem service monitoring in order to evaluate how the Plan achieves regional and national targets andto improve measures if targets are not met. We conclude that direct assessments of environmental objectives are technically and economi- cally feasible, can be attractive to farmers, and are socially fair and of great interest for improving the environmental effectiveness of CAP measures. The explicit and rigorous association of assessments and monitoring, relating specific environmental indicators to regional objectives, should be the main criterion for the approval of the Strategic Plan in an environmentally-focused CAP2023-2030.[ES]: La reforma de la Política Agraria Común (PAC) para el periodo 2021-2027 (extendido en la actualidad a 2023-2030) exige que la Comisión Europea apruebe un Plan Estratégico por cada Estado Miembro con claros objetivos ambientales. En este trabajo desarrollamos recomendaciones específicas para la elaboración del Plan Estratégico para los sistemas agrícolas españoles, basadas en la mejor evidencia científica disponible sobre las relaciones entre la gestión agrícola y los componentes de la biodiversidad. La evidencia científica muestra que España debe 1) identificar objetivos regionales claros relativos a la biodiversidad de los medios agrarios y las medidas a nivel paisajístico necesarias para alcanzarlas; 2) definir criterios ambiciosos y complementarios para los tres instrumentos ambientales (condicionalidad extendida, eco-esquemas y medidas agroambientales y climáticas) de la Arquitectura Verde de la PAC, especialmente en paisajes sencillos y complejos; 3) garantizar que otros instrumentos de la PAC (zonas desfavorecidas, agricultura ecológica y protección de razas ganaderas y variedades de cultivos en peligro de extinción) favorecen realmente la diversidad biológica; 4) mejorar el conocimiento de los agricultores y ajustar las medidas a las limitaciones del mundo real; y 5) invertir en seguimiento de la biodiversidad y sus servicios ecosistémicos asociados con el fin de evaluar si el Plan alcanza los objetivos regionales y nacionales y mejorarlos adaptativamente si no lo consigue. Concluimos que la evaluación directa de los objetivos ambientales es técnica y económicamente viable, puede ser atractiva para los agricultores, es socialmente justa y de gran utilidad en la mejora de la efectividad de las medidas de la PAC. Una combinación rigurosa de seguimiento y evaluación de medidas y objetivos adaptados regionalmente mediante indicadores ambientales directos y claros debería ser el criterio que guíe la aprobación del Plan Estratégico para una PAC 2023-2030 centrada en el medio ambiente y orientada a la conservación de la biodiversidad.Peer reviewe