Interactive Classroom Methods for Science classes

[EN] Interactive methods are a good resource for making students reason and think. This is because they favor open analysis and hypotheses and develop divergent thinking in STEMC subjects. The objectives: students need to build knowledge from intersubjective relationships by studying and working autonomously; develop the ability for self-learning, and publicize trends of perspective development with new methodologies in order to allow teachers and students enrich themselves with these experiences. Applying these methodologies the conclusion is that they are another means for teachers to improve their level of work with their students. In addition, serves to discover the attitudes of the students, their willingness to work and curiosity for research. At the same time, students are able to work in a more practical way the contents and to acquire training and information for their later use in STEMC subjects. Although it is early for results, the ratio of students which have passed the first call exams has beed improved about 10%.Catalán Gallach, I.; Viveros Contreras, R.; Catalán Catalán, JP.; Gallach Vela, MJ. (2020). Interactive Classroom Methods for Science classes. En 6th International Conference on Higher Education Advances (HEAd'20). Editorial Universitat Politècnica de València. (30-05-2020):183-191. https://doi.org/10.4995/HEAd20.2020.11010OCS18319130-05-202

Aprendizaje Cooperativo en Primaria: Teoría, Práctica y Actividades Concretizadas

La calidad educativa depende de la metodología que utilice un centro educativo, con el Aprendizaje Cooperativo se puede mejorar y disminuir el fracaso escolar en Primaria, los alumnos aprenden valores ya perdidos, respetan normas, toman iniciativas y maduran, aprenden y mejoran las habilidades sociales, y nosotros como docentes estamos satisfechos de un mayor logro de los objetivos, contenidos y sobre todo una evaluación más positiva en la que los alumnos tienen una mayor motivación y una mayor comprensión de los temas trabajados. Por tanto, menor fracaso escolar

Artificial pancreas using a personalized rule-based controller achieves overnight normoglycemia in patients with type 1 diabetes

Objective: This study assessed the efficacy of a closed-loop (CL) system consisting of a predictive rule-based algorithm (pRBA) on achieving nocturnal and postprandial normoglycemia in patients with type 1 diabetes mellitus (T1DM). The algorithm is personalized for each patient’s data using two different strategies to control nocturnal and postprandial periods. Research Design and Methods: We performed a randomized crossover clinical study in which 10 T1DM patients treated with continuous subcutaneous insulin infusion (CSII) spent two nonconsecutive nights in the research facility: one with their usual CSII pattern (open-loop [OL]) and one controlled by the pRBA (CL). The CL period lasted from 10 p.m. to 10 a.m., including overnight control, and control of breakfast. Venous samples for blood glucose (BG) measurement were collected every 20 min. Results: Time spent in normoglycemia (BG, 3.9–8.0 mmol/L) during the nocturnal period (12 a.m.–8 a.m.), expressed as median (interquartile range), increased from 66.6% (8.3–75%) with OL to 95.8% (73–100%) using the CL algorithm (P<0.05). Median time in hypoglycemia (BG, <3.9 mmol/L) was reduced from 4.2% (0–21%) in the OL night to 0.0% (0.0–0.0%) in the CL night (P<0.05). Nine hypoglycemic events (<3.9 mmol/L) were recorded with OL compared with one using CL. The postprandial glycemic excursion was not lower when the CL system was used in comparison with conventional preprandial bolus: time in target (3.9–10.0 mmol/L) 58.3% (29.1–87.5%) versus 50.0% (50–100%). Conclusions: A highly precise personalized pRBA obtains nocturnal normoglycemia, without significant hypoglycemia, in T1DM patients. There appears to be no clear benefit of CL over prandial bolus on the postprandial glycemi

Real-Time PCR Improves Helicobacter pylori Detection in Patients with Peptic Ulcer Bleeding

Background and aims: Histological and rapid urease tests to detect H. pylori in biopsy specimens obtained during peptic ulcer bleeding episodes (PUB) often produce false-negative results. We aimed to examine whether immunohistochemistry and real-time PCR can improve the sensitivity of these biopsies. Patients and Methods: We selected 52 histology-negative formalin-fixed paraffin-embedded biopsy specimens obtained during PUB episodes. Additional tests showed 10 were true negatives and 42 were false negatives. We also selected 17 histology-positive biopsy specimens obtained during PUB to use as controls. We performed immunohistochemistry staining and real-time PCR for 16S rRNA, ureA, and 23S rRNA for H. pylori genes on all specimens. Results: All controls were positive for H. pylori on all PCR assays and immunohistochemical staining. Regarding the 52 initially negative biopsies, all PCR tests were significantly more sensitive than immunohistochemical staining (p<0.01). Sensitivity and specificity were 55% and 80% for 16S rRNA PCR, 43% and 90% for ureA PCR, 41% and 80% for 23S rRNA PCR, and 7% and 100% for immunohistochemical staining, respectively. Combined analysis of PCR assays for two genes were significantly more sensitive than ureA or 23S rRNA PCR tests alone (p<0.05) and marginally better than 16S rRNA PCR alone. The best combination was 16S rRNA+ureA, with a sensitivity of 64% and a specificity of 80%. Conclusions: Real-time PCR improves the detection of H. pylori infection in histology-negative formalin-fixed paraffin-embedded biopsy samples obtained during PUB episodes. The low reported prevalence of H. pylori in PUB may be due to the failure of conventional tests to detect infection

Protocolo psicológico para la evaluación de candidatos a implante de neuroestimulador

This review article describes the Psychological Protocol for the evaluation of candidates for neuromodulation implant to be held in the Multidisciplinary Pain Treatment Unit at the University and Polytechnic Hospital "La Fe", in Valencia. Data on cognitive, emotional and sensory factors are collected. An initial opinion is made: positive, negative or partly negative. Patients with positive opinion make a therapy and highly structured group preparation form, accompanied by a collaborator already implanted in this Unity. In this therapy, aspects of pathophysiology of pain, psychological aspects of pain and technical issues are addressed. It impinges on all beliefs and expectations of the patient on the implant and proceeds to the second part, the Surgical Protocol, and to include in the operating room list. The protocol presented is proving to be a valuable tool to discriminate eligible patients, being particularly important psychological preparation.El presente artículo de revisión describe el Protocolo Psicológico para la evaluación de pacientes candidatos a implante de neuromodulación que se realiza en la Unidad Multidisciplinar de tratamiento del Dolor del Hospital Universitario y Politécnico la Fe de Valencia. Se recogen datos sobre factores cognitivos, emocionales y sensoriales. Se realiza un dictamen inicial: positivo, parcialmente negativo o negativo. Los pacientes con dictamen positivo realizan una terapia de preparación de modalidad grupal y muy estructurada, acompañados por un colaborador ya implantado en la Unidad. En esta terapia se abordan aspectos sobre fisiopatología del dolor, aspectos psicológicos del dolor y aspectos técnicos. Se incide sobre todas aquellas creencias y expectativas que tiene el paciente sobre el implante y se procede a la segunda parte, el protocolo quirúrgico, y a incluir en lista de quirófano. El protocolo presentado está demostrando ser un instrumento valioso para discriminar a pacientes idóneos, siendo de especial relevancia la preparación psicológica

The prognostic value of hTERT expression levels in advanced-stage colorectal cancer patients: a comparison between tissue and serum expression

[EN] Aim: Telomeres are regions of highly repetitive, non-coding DNA located at the termini of chromosomes whose principal function is to maintain the structural stability of these ends. In 90% of human tumours, telomere length is maintained by the expression and activation of telomerase reverse transcriptase. Various studies have demonstrated an increase in telomerase activity in tumour tissue, which suggests its possible prognostic value. The main objective of our study was to study the prognostic value of the expression level of telomerase catalytic component (hTERT) in patients with colorectal cancer (CRC). Methods: We analysed the prognostic value of the ratio of telomerase expression in tumour tissue to telomerase expression in the adjacent healthy mucosa and the prognostic value of the expression level of hTERT in the serum of patients diagnosed with CRC. As secondary objectives of the study, we (1) analysed the correlation between telomerase expression in the serum and that in the tumour tissue and (2) analysed the relationship between telomerase expression and different clinical parameters. Results: Peripheral blood and tissue samples taken from 48 patients with CRC were analysed. No significant differences were observed in disease-free survival (DFS) or overall survival time (OST) between the groups of patients categorised based on the ratio of telomerase expression between tumour tissue and healthy tissue. The correlation index (Pearson's coefficient) between telomerase levels in the serum and those in tissue was 0.32. Our study of the relationship between telomerase levels in the serum and different clinical variables, such as tumour size, ganglion affectation, preoperative carcinoembryonic antigen levels and stage, revealed a higher telomerase expression level in patients with stage IV CRC. There was no significant association between telomerase expression in tumour tissue and the clinical parameters analysed. Conclusions: The results obtained in our study do not allow us to propose that the level of telomerase expression be used as a prognostic factor in colorectal cancer. Thus, we cannot consider telomerase expression in the serum as a surrogate marker of its expression in tumour tissue. © 2011 Feseo.This work was made possible by a grant from the Spanish Society of Medical Oncology (SEOM).Safont, MJ.; Gil, M.; Sirera Pérez, R.; Jantus Lewintre, E.; Sanmartín, E.; Gallach, S.; Caballero, C.... (2011). The prognostic value of hTERT expression levels in advanced-stage colorectal cancer patients: a comparison between tissue and serum expression. Clinical & Translational Oncology. 13(6):396-400. doi:10.1007/s12094-011-0673-2S39640013

Molecular subtypes in early colorectal cancer associated with clinical features and patient prognosis

[EN] PurposeAfter surgical resection, an ample prognosis variability among stages is observed. Multiple prognostic factors are individually studied and some CRC classifiers have been proposed. Not one have been implemented into clinical practice.Methods/patientsWe classified 105 patients with resected CRC (stage I-III) into five molecular subtypes using BRAF(V600E) and RAS (KRAS; NRAS) status, and the expression of DNA mismatch repair (MMR) proteins (MLH1 and MSH2). Clinicopathological features and DFS) of distincts groups were evaluated.Results and conclusionsRAS and BRAF(V600E) mutations were detected in 43.8 and 11.4% of patients, respectively. 19% of tumours had lack of expression of any MMR proteins reflecting a system deficiency (dMMR). Patients with any RAS mutation had lower DFS that patients with RAS wild type (wt) (40.23 vs 45.26months; p value=0.035). Of a total of five molecular subtypes, three were MMR proficient (pMMR): RAS mutated (39%), BRAF(V600E) mutated (6.7%) and RAS/BRAF(V600E) wt (35.2%); and two were dMMR: BRAF(V600E) mutated (4.8%) and BRAF(V600E) wt (14.3%). Left side tumours were more frequently observed in pMMR/RAS and BRAF(V600E) wt subtype, and right side tumours in dMMR subtypes. Among the three pMMR subtypes, a benefit survival was observed for patients without any mutation in BRAF(v600E) or RAS oncogenes (median of DFS=45.5 vs 40.98months in RAS mutated group; p=0.084 and vs 34.13 in BRAF(v600E) mutated group; p=0.031). Molecular classification using these biomarkers can be useful to identify groups with differences in prognosis.Gil-Raga, M.; Jantus-Lewintre, E.; Gallach-Garcia, S.; Giner-Bosch, V.; Frangi-Caregnato, AF.; Safont-Aguilera, MJ.; Garde-Noguera, J.... (2018). Molecular subtypes in early colorectal cancer associated with clinical features and patient prognosis. 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Molecular markers identify subtypes of stage III colon cancer associated with patient outcomes. Gastroenterology [Internet]. 2015;148(1):88–99.Osumi H, Shinozaki E, Suenaga M, Matsusaka S, Konishi T, Akiyoshi T, et al. RAS mutation is a prognostic biomarker in colorectal cancer patients with metastasectomy. Int J Cancer. 2016;139(4):803–11.Edge T. AJCC Cancer Staging Handbook. From the AJCC cancer staging manual. 7th ed. In: Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL TA, editor. New York: Springer; 2010.Jass JR. Classification of colorectal cancer based on correlation of clinical, morphological and molecular features. Histopathology. 2007;50:113–30.Leggett B, Whitehall V. Role of the serrated pathway in colorectal cancer pathogenesis. Gastroenterology. 2010;138:2088–100.Douillard J-Y, Oliner KS, Siena S, Tabernero J, Burkes R, Barugel M, et al. Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer. N Engl J Med [Internet]. 2013;369(11):1023–34.Sorich MJ, Wiese MD, Rowland A, Kichenadasse G, McKinnon RA, Karapetis CS. Extended RAS mutations and anti-EGFR monoclonal antibody survival benefit in metastatic colorectal cancer: a meta-analysis of randomized, controlled trials. Ann Oncol [Internet]. 2015;26(1):13–21.Hassabo HM, Sahin IH, Kazmi SMA, Al Mutar SS, Gomes DBD, Pini TM, et al. Associations between patient (pt) colorectal cancer (CRC) tumor KRAS and BRAF mutation (mut) status and overall survival (OS). J Clin Oncol. 2014;32(3_suppl):473.Alberts SR, Sargent DJ, Smyrk TC, Shields AF, Chan E, Goldberg RM, et al. Adjuvant mFOLFOX6 with or without cetuximab (Cmab) in KRAS wild-type (WT) patients (pts) with resected stage III colon cancer (CC):results from NCCTG Intergroup phase III Trial N0147. J Clin Oncol. 2010;28(18s).Lee D-W, Kim KJ, Han S-W, Lee HJ, Rhee YY, Bae JM, et al. 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Real-time PCR improves Helicobacter pylori detection in patients with peptic ulcer bleeding

Background and aims: Histological and rapid urease tests to detect H. pylori in biopsy specimens obtained during peptic ulcer bleeding episodes (PUB) often produce false-negative results. We aimed to examine whether immunohistochemistry and real-time PCR can improve the sensitivity of these biopsies. Patients and Methods: We selected 52 histology-negative formalin-fixed paraffin-embedded biopsy specimens obtained during PUB episodes. Additional tests showed 10 were true negatives and 42 were false negatives. We also selected 17 histology-positive biopsy specimens obtained during PUB to use as controls. We performed immunohistochemistry staining and real-time PCR for 16S rRNA, ureA, and 23S rRNA for H. pylori genes on all specimens. Results: All controls were positive for H. pylori on all PCR assays and immunohistochemical staining. Regarding the 52 initially negative biopsies, all PCR tests were significantly more sensitive than immunohistochemical staining (p<0.01). Sensitivity and specificity were 55% and 80% for 16S rRNA PCR, 43% and 90% for ureA PCR, 41% and 80% for 23S rRNA PCR, and 7% and 100% for immunohistochemical staining, respectively. Combined analysis of PCR assays for two genes were significantly more sensitive than ureA or 23S rRNA PCR tests alone (p<0.05) and marginally better than 16S rRNA PCR alone. The best combination was 16S rRNA+ureA, with a sensitivity of 64% and a specificity of 80%. Conclusions: Real-time PCR improves the detection of H. pylori infection in histology-negative formalin-fixed paraffin-embedded biopsy samples obtained during PUB episodes. The low reported prevalence of H. pylori in PUB may be due to the failure of conventional tests to detect infection

Pain Standards for Accredited Healthcare Organizations (ACDON Project): A Mixed Methods Study

Up to 50% of cancer patients and up to 90% of those in terminal stages experience pain associated with disease progression, poor quality of life, and social impact on caregivers. This study aimed to establish standards for the accreditation of oncological pain management in healthcare organizations. A mixed methods approach was used. First, a pragmatic literature review was conducted. Second, consensus between professionals and patients was reached using the Nominal Group and Delphi technique in a step that involved anesthesiologists, oncologists, family physicians, nurses, psychologists, patient representatives, and caregivers. Third, eight hospitals participated in a pilot assessment of the level of fulfillment of each standard. A total of 37 standards were extracted. The Nominal Group produced additional standards, of which 60 were included in Questionnaire 0 that was used in the Delphi Technique. Two Delphi voting rounds were performed to reach a high level of consensus, and involved 64 and 62 participants with response rates of 90% and 87%, respectively. Finally, 39 standards for the management of cancer pain were agreed upon. In the self-evaluation, the average range of compliance was between 56.4% and 100%. The consensus standards of the ACDON Project might improve the monitoring of cancer pain management. These standards satisfied the demands of professionals and patients and could be used for the accreditation of approaches in cancer pain management