Acuerdo entre los criterios más utilizados para la clasificación de las espondiloartritis (SpA) y el diagnóstico clínico hecho por un reumatólogo experto en un grupo de pacientes jóvenes con dolor lumbar coránico

6 páginasObjective: To evaluate the performance of the most widely used SpA classification criteria in a Colombian group of patients with chronic low back pain. Methods: We assessed the ASAS and the European Spondyloarthropathy Study Group (ESSG) classification criteria in a group of 133 patients who attended consecutively over a period of six months at outpatient clinic of low back pain. All the patients were evaluated with the same protocol. The patients were divided into two groups according to the diagnosis. The diagnosis was compared with the diagnosis made by a expert rheumatologist blinded to patient information. Results: 81 patients with SpA and 52 with other diagnoses were included. There were no differences in age and age of onset of symptoms between the two groups. The SpA group included 55 males and more common clinical findings were: enthesitis, arthritis, sacroiliitis, HLA-B27-positive, previous infection, and dactylitis. The sensitivity and specificity of criteria were: ASAS criteria 96% of sensibility and 80% of specificity, and ESSG criteria 95% and 100% respectively

对工业工程实践进行的360度评估调查的多维度定量研究

عادة ما تكون مبادرة الطلاب واستباقيتهم أثناء تطوير فصول الهندسة محدودة للغاية. ومع ذلك, على عكس الفصول النظرية,  يُظهر الطلاب عادةً اهتمامًا أكبر بالممارسات المختبرية للموضوعات. نظرًا لأن الزيادة في عدد المتسربين من الدورات الهندسية ، فضلاً عن انخفاض الالتحاق, هي حقيقة يتم ملاحظتها أكثر فأكثر, تهدف هذه الدراسة إلى التحليل الكمي لتأثير أداة تقييم 360 درجةفي تقييم الممارسات, في مجموعات طلابية مختلفة لفرع الهندسة الصناعية. وبهذا, فإن الهدف من ذلك هو تحقيق العديد من الأهداف: من ناحية, إشراك الطالب في عملية التقييم, ومن ناحية أخرى, معرفة درجة رضاهم عن المجموعات المختلفة بالتقييم 360 درجة, وكذلك رأي حول الترجيح العادل لكل تقييم. لهذا, يتم تقديم منهجية تستند إلى تطبيق التقييم 360 درجة وتصميم المسح مع 23 سؤالا. كانت هناك ثلاث مراحل من عملية التقييم بزاوية 360 درجة: مشتركة( بين الطلاب)ذاتي( من قبل الطالب نفسه) وتقييم غير متجانسة( من قبل المعلم). في البداية ، تم تصميم استبيان ، والتحقق من صحته من خلال تحليل عامل التأكيد, وتم تحليل الردود على أساس 4 مجموعات مختارة: موضوعان من العامين الأول والأخير, وطريقة التقييم, والجنس( ذكر أو أنثى) والدورة( الدرجة أو الماجستير). تم أيضًا تحليل أفضل ترجيح في الدرجة النهائية لكل مقيِّم, واقتراح القيم المثلى من 50٪ -30٪ -20٪ للتقييم غير المتجانسة, والمشاركة, والتقييم الذاتي, على التوالي. بالإضافة إلى ذلك, أظهرت النتائج درجة عالية من الرضا من جانب المجموعات التي تم تحليلها من خلال الاستبيان وتعكس نضج الطالب.Initiative and proactiveness shown by students during engineering lectures is usually very limited. However, students usually show high levels of interest in practical laboratory sessions. In order to address increasing dropout from engineering courses, as well as decreased enrollment, the present study aims to quantitatively analyze the impact of a 360-degree feedback survey for evaluating practical sessions. Analysis was conducted overall and as a function of industrial engineering students. Several objectives are intended to be achieved. Firstly, the study aimed to engage students in the evaluation process and, secondly, identify satisfaction with 360-degree feedback as a function of different groupings, whilst, at the same time, gathering opinions about the fairness of evaluation. To this end, a methodology based on the application of 360-degree feedback was applied and a 23-question survey was administered. The following three stages were followed for the 360-degree feedback evaluation process: co- (between students), self- (the student themself) and hetero-evaluation (lecturer). Initially, a questionnaire was designed and validated using confirmatory factor analysis. Responses were analyzed as a function of 4 groups: module (one first- and one third-year module), evaluation type, sex (male or female) and degree level (BSc or MSc). The most appropriate weighting to be applied to each evaluation in order to produce a final overall score was also analysed. This suggested optimal values ​​of 50%, 30% and 20% for the hetero-, co- and self-evaluations, respectively. Additionally, outcomes revealed a high degree of satisfaction for all analysed groupings and high level of maturity in participating students.La iniciativa y la proactividad del alumnado de Ingeniería durante el desarrollo de las clases teóricas es normalmente muy limitada, al contrario que en las prácticas de laboratorio donde muestra más interés. Se constata un aumento del abandono en las carreras de ingeniería y una disminución de matriculados y este estudio tiene como finalidad analizar cuantitativamente el impacto de una herramienta de evaluación 360 grados encuestada en la evaluación de prácticas en estudiantes de ingeniería industrial. Se pretenden lograr varios objetivos: por un lado, implicar al estudiante en el proceso de evaluación y, por otro, conocer su grado de satisfacción con este tipo de evaluación, así como su opinión sobre la ponderación justa. Se Sigue una metodología basada en la aplicación de la evaluación 360 grados y un diseño de encuesta con 23 preguntas. Las etapas del proceso de evaluación 360 grados fueron tres: co- (entre estudiantes), auto- (por el propio estudiante) y hetero-evaluación (por el docente). Se diseñó un cuestionario, validado mediante análisis factorial confirmatorio, y se procedió al análisis de las respuestas en base a 4 agrupaciones seleccionadas: dos asignaturas de primeros y últimos cursos, modalidad de evaluación, sexo (hombre o mujer) y ciclo (Grado o Máster). También se ha analizado la mejor ponderación en la calificación final para cada evaluador, proponiéndose como óptimos los valores 50%-30%-20% para la hetero-, co- y autoevaluación, respectivamente. Los resultados muestran un elevado grado de satisfacción por parte de los grupos analizados a través de la encuesta y adecuada maduración del estudiante.A iniciativa e a proatividade dos alunos durante as aulas de engenharia são geralmente muito limitadas. No entanto, ao contrário os alunos tendem a mostrar mais interesse pelas práticas laboratoriais das disciplinas. Dado que o aumento de desistências nos cursos de engenharia, bem como a diminuição de matrículas, este estudo tem como objetivo analisar quantitativamente o impacto de uma ferramenta de avaliação de 360 graus inquirida na avaliação de aulas práticas, em estudantes da engenharia industrial. Pretende-se, assim, atingir vários objetivos: por um lado, envolver o estudante no processo de avaliação e, por outro, conhecer o seu grau de satisfação de diferentes grupos com avaliação, bem como a sua opinião sobre a ponderação justa de cada avaliação. Para isso, apresenta-se uma metodologia baseada na aplicação da avaliação de 360 graus e a elaboração de um questionário com 23 perguntas. As fases do processo de avaliação de 360 graus eram três: co- (entre estudantes), auto- (pelo próprio estudante) e heteroavaliação (pelo docente). Inicialmente, foi elaborado um questionário, validado por análise fatorial confirmatória, e procedeu-se à análise das respostas com base em 4 grupos selecionados: duas disciplinas dos primeiros e últimos anos, modo de avaliação, sexo (masculino ou feminino) e ciclo (Licenciatura ou Mestrado). Foi também analisada a melhor ponderação na nota final para cada avaliador, propondo-se como ótimos os valores 50%-30%-20% para a hetero-, co- e autoavaliação, respetivamente. Além disso, os resultados revelaram um elevado grau de satisfação por parte dos grupos analisados através, o que reflete a maturidade do estudante.A iniciativa e a proatividade dos alunos durante as aulas de engenharia são geralmente muito limitadas. No entanto, ao contrário os alunos tendem a mostrar mais interesse pelas práticas laboratoriais das disciplinas. Dado que o aumento de desistências nos cursos de engenharia, bem como a diminuição de matrículas, este estudo tem como objetivo analisar quantitativamente o impacto de uma ferramenta de avaliação de 360 graus inquirida na avaliação de aulas práticas, em estudantes da engenharia industrial. Pretende-se, assim, atingir vários objetivos: por um lado, envolver o estudante no processo de avaliação e, por outro, conhecer o seu grau de satisfação de diferentes grupos com avaliação, bem como a sua opinião sobre a ponderação justa de cada avaliação. Para isso, apresenta-se uma metodologia baseada na aplicação da avaliação de 360 graus e a elaboração de um questionário com 23 perguntas. As fases do processo de avaliação de 360 graus eram três: co- (entre estudantes), auto- (pelo próprio estudante) e heteroavaliação (pelo docente). Inicialmente, foi elaborado um questionário, validado por análise fatorial confirmatória, e procedeu-se à análise das respostas com base em 4 grupos selecionados: duas disciplinas dos primeiros e últimos anos, modo de avaliação, sexo (masculino ou feminino) e ciclo (Licenciatura ou Mestrado). Foi também analisada a melhor ponderação na nota final para cada avaliador, propondo-se como ótimos os valores 50%-30%-20% para a hetero-, co- e autoavaliação, respetivamente. Além disso, os resultados revelaram um elevado grau de satisfação por parte dos grupos analisados através, o que reflete a maturidade do estudante.在工程课上，学生表现出来的主动性和积极性往往不高。但跟理论课相反，在学科实验课上学生常常表现出更多的兴趣。考虑到工程专业逐年提升的弃学率，和逐年下降的注册率，该研究希望对一测量工具的影响进行定量分析。该工具可以在360度的范围内对工业工程专业的不同学生群体进行实践评估，以此来达成以下目标：一让学生参与到评估过程；二通过360度评估了解不同群体的满意度以及他们对每项评估权重的意见。为了实现上述目标，研究使用360度评估方法和包含23个问题的问卷调查。360度评估过程分为三个阶段：相互评估（学生与学生之间）、自我评估（由学生自己进行）和异体评估（由老师进行）。首先设计了一个通过验证性因素分析的问卷，然后对问卷答案进行分析。我们将答案分成四组：低年级和高年级的两门课程、评估类型、性别（男或女）以及学历周期（本科或研究生）。除此之外我们还对每项评估员最终打分的最优权重进行了分析，提出异体、相互和自我评估阶段的最佳值为50%、30%和20%。最后问卷结果还显示出不同分析群体的满意度都很高，这也一定程度上反映了学生的成熟度

Design and Assessment of Survey in a 360-Degree Feedback Environment for Student Satisfaction Analysis Applied to Industrial Engineering Degrees in Spain

The number of students enrolled in engineering studies in Spain is in decline, mainly due to the difficulty in passing the subjects, whose factors may be linked to the science-related content of the subject, a very demanding evaluation system or a lack of active participation of students. The main objective of this study is to provide the student with a 360-degree feedback tool and a survey, from which lecturers can extract the degree of satisfaction of students in its application in a standardized way in scientific-technological activities of BSc/MSc in industrial engineering to quantify learning and motivation. The involvement of students in the assessment process was carried out in three phases: peer-assessment (among students), self-assessment (student himself) and hetero-assessment (teaching staff). After that, a survey was designed, which was validated through confirmatory factor analysis. Ninety-nine percent of the students valued this evaluation experience very positively with respect to the objectivity of the criteria used in the methodology and the material provided by the teaching staff. The fact that only 37.5% of the students considered this experience very favorable for their learning and self-training shows the importance of the teaching staff in their learning process and suggests a need to find complementary improvements to this evaluation system in industrial engineering degrees

Development of lessons on chemical and biological reactors in Moodle platform

En este proyecto docente se han desarrollado una serie de actividades académicamente dirigidas dedicadas a los reactores químicos y biológicos, en concreto, se ha empleado una herramienta denominada lección que se encuentra disponible a través de la plataforma virtual Moodle, dichas lecciones se basan en una serie de ventanas secuenciales que permiten profundizar en todos los conceptos fundamentales de los reactores químicos y/o biológicos y, a través de diversas cuestiones complementarias sobre el tema, incluidas durante el desarrollo de dicha lección, permite al alumno realizar un aprendizaje más activo que favorece la consolidación de los conceptos de forma gradual. Previo al estudio de los reactores químicos y/o biológicos es necesario tener en cuenta diversos aspectos químicos, físicos, matemáticos, biológicos e ingenieriles que han de considerarse para desarrollar los aspectos fundamentales básicos para poder alcanzar dicho objetivo y se pretende facilitar esta labor al alumnado con el empleo de las lecciones elaboradas. Previamente a la elaboración de las lecciones se ha realizado una importante labor de preparación y síntesis de toda la información, posteriormente se han desarrollado diferentes lecciones para los conceptos tratados en cada uno de los temas implicados en la elaboración de este proyecto docente y tras una profunda revisión se han puesto a disposición de los alumnos.In this teaching project have developed a series of academic activities devoted to the chemical and biological reactors, in particular, it has been using a tool called lesson which is available through the Moodle virtual platform, these lessons are based on a series of sequential windows allowing to delve into all the fundamental concepts of chemical and/or biological reactors and through various complementary on the theme, including issues during the development of this lesson, students perform a more active learning that promotes the consolidation of concepts gradually. Prior to the study of chemical reactors and/or biological is necessary to take account of various chemical, physical, mathematical, biological and engineering aspects that are to be considered to develop the basic fundamentals to achieve the aim and is intended to facilitate this work to the students with the use of elaborate lessons. Important preparation work has been prior to the preparation of the lessons and synthesis of information, have subsequently developed different lessons for the concepts dealt with in each of the issues involved in the development of this educational project and after a thorough review have been available to the students

Anti-Spike antibodies 3 months after SARS-CoV-2 mRNA vaccine booster dose in patients on hemodialysis: the prospective SENCOVAC study

Background: Patients on hemodialysis are at high-risk for complications derived from coronavirus disease 2019 (COVID-19). The present analysis evaluated the impact of a booster vaccine dose and breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections on humoral immunity 3 months after the booster dose. Methods: This is a multicentric and prospective study assessing immunoglobulin G anti-Spike antibodies 6 and 9 months after initial SARS-CoV-2 vaccination in patients on hemodialysis that had also received a booster dose before the 6-month assessment (early booster) or between the 6- and 9-month assessments (late booster). The impact of breakthrough infections, type of vaccine, time from the booster and clinical variables were assessed. Results: A total of 711 patients [67% male, median age (range) 67 (20-89) years] were included. Of these, 545 (77%) received an early booster and the rest a late booster. At 6 months, 64 (9%) patients had negative anti-Spike antibody titers (3% of early booster and 29% of late booster patients, P =. 001). At 9 months, 91% of patients with 6-month negative response had seroconverted and there were no differences in residual prevalence of negative humoral response between early and late booster patients (0.9% vs 0.6%, P =. 693). During follow-up, 35 patients (5%) developed breakthrough SARS-CoV-2 infection. Antibody titers at 9 months were independently associated with mRNA-1273 booster (P =. 001), lower time from booster (P =. 043) and past breakthrough SARS-CoV-2 infection (P <. 001). Conclusions: In hemodialysis patients, higher titers of anti-Spike antibodies at 9 months were associated with mRNA-1273 booster, lower time from booster and past breakthrough SARS-CoV-2 infectionThe present project has been supported by Fresenius Medical Care, Diaverum, Vifor Pharma, Vircell, Fundación Renal Iñigo Álvarez de Toledo and ISCIII FEDER funds RICORS2040 (RD21/0005

Spanish cohort of VEXAS syndrome : clinical manifestations, outcome of treatments and novel evidences about UBA1 mosaicism

The vacuoles, E1-enzyme, X linked, autoinflammatory and somatic (VEXAS) syndrome is an adult-onset autoinflammatory disease (AID) due to postzygotic UBA1 variants. To investigate the presence of VEXAS syndrome among patients with adult-onset undiagnosed AID. Additional studies evaluated the mosaicism distribution and the circulating cytokines. Gene analyses were performed by both Sanger and amplicon-based deep sequencing. Patients' data were collected from their medical charts. Cytokines were quantified by Luminex. Genetic analyses of enrolled patients (n=42) identified 30 patients carrying UBA1 pathogenic variants, with frequencies compatible for postzygotic variants. All patients were male individuals who presented with a late-onset disease (mean 67.5 years; median 67.0 years) characterised by cutaneous lesions (90%), fever (66.7%), pulmonary manifestations (66.7%) and arthritis (53.3%). Macrocytic anaemia and increased erythrocyte sedimentation rate and ferritin were the most relevant analytical abnormalities. Glucocorticoids ameliorated the inflammatory manifestations, but most patients became glucocorticoid-dependent. Positive responses were obtained when targeting the haematopoietic component of the disease with either decitabine or allogeneic haematopoietic stem cell transplantation. Additional analyses detected the UBA1 variants in both haematopoietic and non-haematopoietic tissues. Finally, analysis of circulating cytokines did not identify inflammatory mediators of the disease. Thirty patients with adult-onset AID were definitively diagnosed with VEXAS syndrome through genetic analyses. Despite minor interindividual differences, their main characteristics were in concordance with previous reports. We detected for the first time the UBA1 mosaicism in non-haematopoietic tissue, which questions the previous concept of myeloid-restricted mosaicism and may have conceptual consequences for the disease mechanisms

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Asociación del antígeno de histocompatibilidad HLA-B15 y espondiloartritis, su influencia en la presentación clínica y pronóstico en la cohorte de pacientes del Hospital Militar Central

Las Espondiloartritis (SpA), llamadas artritis seronegativas, son un grupo frecuente de enfermedades reumáticas que afectan a personas jóvenes, especialmente hombres menores de 45 años, generando una importante discapacidad y alteración de la calidad de vida producto de la afección de las articulaciones de la columna vertebral, especialmente el segmento lumbar y sacro, al igual que en las articulaciones de los miembros inferiores. Tradicionalmente en este grupo de enfermedades se ha identificado e investigado la forma más severa de presentación clínica llamada Espondilitis Anquilosante (AS), caracterizada por la formación de puentes óseos entre la vertebras que generan la imagen radiológica de ?columna en caña de bambú? y la presencia del alelo HLA-B27 en más del 90% de los enfermos. Esta forma es la más frecuente presentación clínica en población blanca de origen anglosajón. En nuestro medio la AS es menor al 40% de todas las SpA, como ha sido ya reportado en la cohorte del Hospital Militar. Más del 60% de los enfermos Colombianos corresponden a formas no definidas de enfermedad (uSpA), llamadas así por el hecho de presentar todo el conjunto de signos y de síntomas, pero que no pueden ser clasificadas como AS por la ausencia de compromiso radiológico ?anquilótico? a nivel de la columna vertebral. La asociación errónea de las SpA con estados severos de enfermedad representados por ?anquilosis? ha limitado la posibilidad de establecer un diagnóstico adecuado en los pacientes con formas en estadios tempranos o con enfermedad leve plenamente establecida. Muchos pacientes son mal diagnosticados como lumbago común, hernias de disco, espondilo artrosis de columna o fibromialgia. Un detenido análisis clínico podría superar esta barrera diagnostica en la mayoría de los casos. Existe información que permite suponer que al menos en poblaciones mestizas latinoamericanas las formas uSpA, conformarían una categoría definida de enfermedad, con características propias en lo relacionado con una edad de inicio más tardía y el mejor pronostico en el tiempo. La ausencia del B27 y la presencia del B15, podría explicar este comportamiento. De la misma forma el establecer una posible relación entre la enfermedad y subtipo específico de B15 daría un sentido biológico a la relación y abriría un campo de investigación en procura de mejor información relacionada con la etiología de la enfermedad. Por tal motivo se estudió el polimorfismo del HLA-B15 en las Espondiloartritis de los pacientes atendidos en el Servicio de Reumatología del Hospital Militar CentralDoctor en Ciencias - BiologíaDoctorad

Associations of the Levels of C4d-bearing Reticulocytes and High-avidity Anti-dsDNA Antibodies with Disease Activity in Systemic Lupus Erythematosus

9 páginasObjective There are no laboratory tools that detect early flares in systemic lupus erythematosus (SLE). Our aim was to validate in our population the previous findings of the association of C4d-bearing reticulocytes (R-C4d) compared to anti-dsDNA antibodies, with disease activity assessed by the Safety of Estrogens in Lupus Erythematosus National Assessment–Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) and the British Isles Lupus Assessment Group (BILAG) 2004 scales. Methods All patients who met the 1987 American College of Rheumatology classification criteria and were seen consecutively in 2013 at a specialized SLE care clinic were included. Disease activity was established by the SELENA-SLEDAI and BILAG 2004. Anti-dsDNA and R-C4d were quantified in peripheral blood. Comparisons were made between values of active and inactive patients, and the correlations between the SELENA-SLEDAI and serum levels of anti-dsDNA and R-C4d were measured. Results Sixty-two patients (83.9% women) were included. A total of 32.3% had active disease according to the SELENA-SLEDAI. There was a significant statistical difference (p = 0.0001) in the distribution of R-C4d between disease activity groups. The correlation coefficient between R-C4d and the SELENA-SLEDAI score was rs = 0.738 (p = 0.0001). R-C4d differed between patients with and without activity in the BILAG 2004 constitutional, mucocutaneous, gastrointestinal, renal, and hematological domains. Conclusion R-C4d showed a higher correlation with SLE activity measured by the SELENA-SLEDAI and BILAG 2004 than anti-dsDNA did, suggesting a possible involvement in diagnosing disease activity. Prospective studies that confirm these findings and evaluate its involvement in followup are needed