Search

Not available.

En un contexto socioeconómico cambiante se reclama una enseñanza superior personalizada y permanente que sea adecuada a los nuevos perfiles profesionales versátiles y a la sociedad digital que evoluciona continuamente e invita a repensar qué, cómo, dónde y cuándo aprender. En este marco, la tutoría universitaria se convierte en un proceso imprescindible para acompañar a los estudiantes que enfrentarán el futuro incierto, con el fin de dotarles de recursos para su óptimo desarrollo. Con esto en mente, este artículo plantea como objetivo conocer cómo los estudiantes utilizan y valoran la tutoría en su formación universitaria, a través de un diseño metodológico descriptivo tipo encuesta, que se aplica a 625 estudiantes de los cuatro títulos de grado de la Facultad de Educación de la Universidad de Murcia. Los análisis realizados muestran un pobre desarrollo de la tutoría universitaria, aún más concentrada en los aspectos académicos que en el desarrollo personal o profesional. Por lo tanto, el artículo señala algunas áreas de mejora de la tutoría, entre ellas, la importancia de informar mejor al alumnado sobre esta o de las herramientas tecnológicas para fortalecer la relación tutorial.

This study screened for Fabry disease (FD) in patients in hemodialysis (HD) in the region of Madrid (CAM) with a cross-sectional design to evaluate HD-prevalent patients, followed by a three-year period prospective design to analyze HD-incident patients. Inclusion criteria: patients older than 18 years on HD in the CAM, excluding patients diagnosed with any other hereditary disease with renal involvement different from FD, that sign the Informed Consent (IC). Exclusion criteria: underaged patients or not agreeing or not being capable of signing the IC. Results: 3470 patients were included, 63% males and with an average age of 67.9 ± 9.7 years. 2357 were HD-prevalent patients and 1113 HD-incident patients. For HD-prevalent patients, average time in HD was 45.2 months (SD 51.3), in HD-incident patients proteinuria was present in 28.4%. There were no statistical differences in plasmatic alpha-galactosidase A (α-GAL-A) activity or Lyso-GL-3 values when comparing HD-prevalent and HD-incident populations and neither between males and females. A genetic study was performed in 87 patients (2.5% of patients): 60 male patients with decreased enzymatic activity and 27 female patients either with a decreased GLA activity, increased Lyso-Gl3 levels or both. The genetic variants identified were: p.Asp313Tyr (4 patients), p.Arg220Gln (3 patients) and M290I (1 patient). None of the identified variants is pathogenic. Conclusions: 76% of HD Centers of the CAM participated in the study. This is the first publication to describe the prevalence of FD in the HD-population of a region of Spain as well as its average α-GAL-A-activity and plasmatic Lyso-Gl3 levels. It is also the first study that combines a cross-sectional design with a prospective follow-up design. This study has not identified any FD patient. Resumen: El objetivo del estudio ha sido realizar un mapa descriptivo de la enfermedad de Fabry (EF) en la Comunidad de Madrid, así como realizar un despistaje de la EF a todo paciente incidente durante un período de 3 años. Criterios de inclusión: Pacientes mayores de 18 años, excluyendo aquellos diagnosticados de cualquier otra enfermedad hereditaria con afectación renal diferente de la EF, que firmaran el consentimiento informado. Criterios de exclusión: pacientes menores de edad, no estar de acuerdo o no ser capaces de firmar el consentimiento informado. Resultados: Se incluyeron 3.470 pacientes (63% hombres), con una edad media de 67,9 ± 9,7 años, de los cuales 2.357 eran pacientes prevalentes y 1.113 incidentes. En el caso de los pacientes prevalentes, el tiempo medio en hemodiálisis (HD) fue de 45,2 (DE 51,3) meses. En pacientes incidentes, la proteinuria estuvo presente en el 28,4%. No hubo diferencias estadísticamente significativas en la actividad plasmática de alfa-galactosidasa A o valores de Lyso-Gl3 al comparar las poblaciones de incidentes y de prevalentes, y tampoco entre hombres y mujeres. Se realizó estudio genético en 87 pacientes (2,5% de los pacientes): 60 varones con disminución de la actividad enzimática y 27 mujeres con una disminución de la actividad enzimática, aumento de los niveles de Lyso-Gl3 o ambos. Las variantes genéticas identificadas fueron: p.Asp313Tyr (4 pacientes), p.Arg220Gln (3 pacientes) y M290I (un paciente). Ninguna de las variantes identificadas fue patógena. Conclusiones: El 76% de los centros de HD de la Comunidad de Madrid participaron en el estudio. Este es el primer estudio epidemiológico prospectivo de EF en la población de HD de una región de España. También es la primera vez que se describen niveles de alfa-galactosidasa A y Lyso-Gl3 en HD, sin embargo, en este estudio no se han identificado pacientes con EF.

Abstract Background CPX‐351 is approved for the treatment of therapy related acute myeloid leukemia (t‐AML) and AML with myelodysplastic related changes (MRC‐AML). The benefits of this treatment over standard chemotherapy has not been addressed in well matched cohorts of real‐life patients. Methods Retrospective analysis of AML patients treated with CPX‐351 as per routine practice. A propensity score matching (PSM) was used to compare their main outcomes with those observed in a matched cohort among 765 historical patients receiving intensive chemotherapy (IC), all of them reported to the PETHEMA epidemiologic registry. Results Median age of 79 patients treated with CPX‐351 was 67 years old (interquartile range 62–71), 53 were MRC‐AML. The complete remission (CR) rate or CR without recovery (CRi) after 1 or 2 cycles of CPX‐351 was 52%, 60‐days mortality 18%, measurable residual disease

Abstract Next-Generation Sequencing is needed for the accurate genetic risk stratification of acute myeloid leukemia according to European LeukemiaNet (ELN) guidelines. We validated and compared the 2022 ELN risk classification in a real-life cohort of 546 intensively and 379 non-intensively treated patients. Among fit patients, those aged ≥65 years old showed worse OS than younger regardless risk classification. Compared with the 2017 classification, 14.5% of fit patients changed the risk with the 2022 classification, increasing the high-risk group from 44.3% to 51.8%. 3.7% and 0.9% FLT3-ITD mutated patients were removed from the favorable and adverse 2017 categories respectively to 2022 intermediate risk group. We suggest that midostaurin therapy could be a predictor for 3 years OS (85.2% with vs. 54.8% without midostaurin, P = 0.04). Forty-seven (8.6%) patients from the 2017 intermediate group were assigned to the 2022 adverse-risk group as they harbored myelodysplasia (MDS)-related mutations. Patients with one MDS-related mutation did not reach median OS, while patients with ≥2 mutations had 13.6 months median OS (P = 0.002). Patients with TP53 ± complex karyotype or inv(3) had a dismal prognosis (7.1 months median OS). We validate the prognostic utility of the 2022 ELN classification in a real-life setting providing supportive evidences to improve risk stratification guidelines.

Background and aimsThe diagnosis of malnutrition in post-critical COVID-19 patients is challenging as a result of the high prevalence of obesity, as well as the variability and previously reported inconsistencies across currently available assessment methods. Bioelectrical impedance vector analysis (BIVA) with phase angle (PhA) and nutritional ultrasound (NU®) are emerging techniques that have been proven successful in assessing body composition with high precision in previous studies. Our study aims to determine the performance and usefulness of PhA and rectus femoris cross-sectional area (RF-CSA) measurements in assessing body composition as part of the full routine morphofunctional assessment used in the clinical setting, as well as their capacity to predict severe malnutrition and to assess complications and aggressive therapy requirements during recent intensive care unit (ICU) admission, in a cohort of post-critically ill COVID-19 outpatients.MethodsThis prospective observational study included 75 post-critical outpatients who recovered from severe COVID-19 pneumonia after requiring ICU admission. Correlations between all the morphofunctional parameters, complications, and aggressive therapy requirements during admission were analyzed. Multivariate logistic regression analysis and ROC curves were provided to determine the performance of NU® and PhA to predict severe malnutrition. Differences in complications and aggressive therapy requirements using the cutoff points obtained were analyzed.ResultsIn total, 54.7% of patients were classified by Subjective Global Assessment (SGA) as SGA-B and 45.3% as SGA-C, while 78.7% met the Global Leadership Initiative of Malnutrition (GLIM) criteria. PhA correlates positively with body cell mass/height (BCM/h) (r = 0.74), skeletal muscle index (SMI) (r = 0.29), RF-CSA (r = 0.22), RF-Y axis (r = 0.42), and handgrip strength (HGS) assessed using dynamometry (r = 0.42) and the Barthel scale (r = 0.29) and negatively with ICU stay (r = −0.48), total hospital stay (r = −0.57), need for invasive mechanical ventilation (IMV) (r = −0.39), days of IMV (r = −0.41), need for tracheostomy (r = −0.51), and number of prone maneuvers (r = −0.20). RF-CSA correlates positively with BCM/h (r = 0.41), SMI (r = 0.58), RF-Y axis (r = 0.69), and HGS assessed using dynamometry (r = 0.50) and the Barthel scale (r = 0.15) and negatively with total hospital stay (r = −0.22) and need for IMV (r = −0.28). Cutoff points of PhA < 5.4° and standardized phase angle (SPhA) < −0.79 showed good capacity to predict severe malnutrition according to SGA and revealed differences in ICU stay, total hospital stay, number of prone maneuvers, need for IMV, and need for rehabilitation, with statistical significance (p < 0.05). An RF-CSA/h < 2.52 cm2/m (for men) and

El estudio de los planes curriculares de la formación inicial para el ejercicio de la docencia en Educación Secundaria, entendidos como artefactos histórico-culturales mediadores en la práctica docente, permite comprender qué profesionales se pretenden formar. En el presente trabajo se analiza cómo se abordan los contenidos y las competencias sobre orientación y acción tutorial en las guías elaboradas por los distintos másteres oficiales de formación del profesorado de Educación Secundaria que imparten 43 universidades españolas. Se ha realizado un análisis documental de guías docentes clasificando los contenidos en función de si el contenido de orientación y acción tutorial se plantea como una materia específica, si está integrado en otras materias y si forma parte de un módulo genérico o de libre disposición. Los resultados de los análisis descriptivos de las 65 guías seleccionadas ponen de manifiesto que no hay unanimidad respecto al abordaje de la orientación y de la acción tutorial en dichos másteres. No obstante, sí se focalizan dos grupos de modelos (modelo de currículum con representación integrada y modelo de currículum con asignatura específica) concretados en varios diseños, aunque su análisis evidencia que en pocos casos la orientación y la acción tutorial es abordada en profundidad.

Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) and R-bendamustine (R-B) are the most common frontline treatment strategies for advanced-stage follicular lymphoma (FL). After R-CHOP induction therapy, using rituximab for maintenance therapy notably improves outcomes; however, whether this can be achieved by using the same approach after R-B therapy is still being determined. This retrospective analysis compared 476 FL patients from 17 GELTAMO centers who received R-based regimens followed by rituximab maintenance therapy for untreated advanced-stage FL. The complete response rate at the end of induction was higher with R-B and relapses were more frequent with R-CHOP. During induction, cytopenias were significantly more frequent with R-CHOP and so was the use of colony-stimulating factors. During maintenance therapy, R-B showed more neutropenia and infectious toxicity. After a median follow-up of 81 months (95% CI: 77–86), the 6-year rates of progression-free survival (PFS) were 79% (95% CI: 72–86) for R-bendamustine vs. 67% (95% CI: 61–73) for R-CHOP (p = 0.046), and 6-year overall survival (OS) values were 91% (95% CI: 86–96) for R-B vs. 91% (95% CI: 87–94) for R-CHOP (p = 0.49). In conclusion, R-B followed by rituximab maintenance therapy in patients with previously untreated FL resulted in significantly longer PFS than R-CHOP, with older patients also benefiting from this treatment without further toxicity. Adverse events during maintenance were more frequent with R-B without impacting mortality.

A greater understanding of clinical trends in COVID-19 outcomes among patients with hematologic malignancies (HM) over the course of the pandemic, particularly the Omicron era, is needed. This ongoing, observational, and registry-based study with prospective data collection evaluated COVID-19 clinical severity and mortality in 1818 adult HM patients diagnosed with COVID-19 between 27 February 2020 and 1 October 2022, at 31 centers in the Madrid region of Spain. Of these, 1281 (70.5%) and 537 (29.5%) were reported in the pre-Omicron and Omicron periods, respectively. Overall, patients aged ≥70 years (odds ratio 2.16, 95% CI 1.64–2.87), with >1 comorbidity (2.44, 1.85–3.21), or with an underlying HM of chronic lymphocytic leukemia (1.64, 1.19–2.27), had greater odds of severe/critical COVID-19; odds were lower during the Omicron BA.1/BA.2 (0.28, 0.2–0.37) or BA.4/BA.5 (0.13, 0.08–0.19) periods and among patients vaccinated with one or two (0.51, 0.34–0.75) or three or four (0.22, 0.16–0.29) doses. The hospitalization rate (75.3% [963/1279], 35.7% [191/535]), rate of intensive care admission (30.0% [289/963], 14.7% [28/191]), and mortality rate overall (31.9% [409/1281], 9.9% [53/536]) and in hospitalized patients (41.3% [398/963], 22.0% [42/191]) decreased from the pre-Omicron to Omicron period. Age ≥70 years was the only factor associated with higher mortality risk in both the pre-Omicron (hazard ratio 2.57, 95% CI 2.03–3.25) and Omicron (3.19, 95% CI 1.59–6.42) periods. Receipt of prior stem cell transplantation, COVID-19 vaccination(s), and treatment with nirmatrelvir/ritonavir or remdesivir were associated with greater survival rates. In conclusion, COVID-19 mortality in HM patients has decreased considerably in the Omicron period; however, mortality in hospitalized HM patients remains high. Specific studies should be undertaken to test new treatments and preventive interventions in HM patients.

El uso de las tecnologías de la información y comunicación (TIC) en educación superior se ha generalizado durante los últimos años, mientras que su aplicación en la vida cotidiana es ya omnipresente. Sin embargo, su presencia y utilización en los procesos orientación y tutoría universitaria son más escasos. Con este trabajo se pretende evaluar una innovación docente que potencia la tutoría universitaria con el uso de dos herramientas tecnológicas: Kahoot y foros virtuales. Desde una metodología de investigación cuantitativa, participan 238 estudiantes de la Facultad de Educación de la Universidad de Murcia con la cumplimentación de una escala de satisfacción diseñada ad hoc. Los resultados denotan una escala adecuada a los datos que se pretenden medir con un Alfa de Cronbach elevado. También muestran una elevada satisfacción del alumnado con la herramienta Kahoot y con la realización de tutorías a demanda del propio docente con ayuda de las herramientas digitales como también se destaca en otros estudios sobre Kahoot (Reynolds et al., 2021) y tutorías universitarias (Castillo y Aguilar, 2021). La menor satisfacción con el desarrollo de los foros virtuales invita a analizarlos, en plena educación 4.0, desde una perspectiva cualitativa (Ajjawi y Boud, 2018) en futuras investigaciones.

Abstract Background Couple relationship distress is common and associated with poor physical, psychological, and relational outcomes for both partners. Emotionally Focused Therapy for couples (EFT) is a short-term structured approach based on attachment theory that integrates a humanistic, experiential approach to restructuring emotional experience and a systemic structural approach to restructuring interactions. This model has been shown to be an effective treatment for couple distress. The supporting research, however, has only been conducted with English-speaking couples. Despite Spanish being the second-most spoken language and meaningful cultural differences between English- and Spanish-speaking countries, the efficacy of EFT has not been examined in this cultural context. This study will examine the efficacy of EFT in this particular context and advance the understanding of potential mechanisms of change. Methods We will use a multicenter randomized wait-list controlled design to examine the efficacy of EFT in a Spanish-speaking sample of moderately distressed couples. One hundred forty individuals in 70 couples in Argentina, Costa Rica, Guatemala, Mexico, and Spain will be randomly assigned to receive 19–21 sessions of EFT or be placed on a waitlist. Outcomes on a range of relational and individual mental health variables will be assessed prior to random assignment, throughout treatment, and at the conclusion of treatment. Primary outcomes will include dyadic adjustment, couple satisfaction, and attachment. Secondary variables, such as loneliness, parenting, affective communication, and sexual satisfaction, will be included as potential mediators of the treatment effect. Couples in the treatment group will also be assessed at 3-, 6-, 12-, 18-, and 24-month follow-ups. Process variables such as the therapeutic alliance will also be assessed routinely in couples assigned to the treatment group. Couples in the waitlist will receive a psycho-educational program based on EFT after completing the study. Discussion This study will be the first RCT of Emotionally Focused Therapy in a Spanish-speaking context. The results of the study will inform researchers interested in whether treatments developed and tested in the USA and Canada can be effective in differing cultural contexts. It may also point researchers and clinicians to areas where cultural adaptation is needed to improve efficacy. Trial registration ClinicalTrials.gov NCT04277325. Registered on February 20, 2020

Abstract In a context of therapeutic revolution in older adults with AML, it is becoming increasingly important to select patients for the various treatment options by taking account of short-term efficacy and toxicity as well as long-term survival. Here, the data from three European registries for 1,199 AML patients aged 70 years or older treated with intensive chemotherapy were used to develop a prognostic scoring system. The median follow-up was 50.8 months. In the training set of 636 patients, age, performance status, secondary AML, leukocytosis, and cytogenetics, as well as NPM1 mutations (without FLT3-ITD), were all significantly associated with overall survival, albeit not to the same degree. These factors were used to develop a score that predicts long-term overall survival. Three risk-groups were identified: a lower, intermediate and higher-risk score with predicted 5-year overall survival (OS) probabilities of ≥12% (n = 283, 51%; median OS = 18 months), 3–12% (n = 226, 41%; median OS = 9 months) and

Diseñar y desarrollar procesos formativos que partan del análisis de problemas contextualizados es el fin del Aprendizaje Basado en Problemas (ABP), una metodología interesante en las carreras de Ingeniería para lograr aprendizajes significativos. El propósito general de este artículo es dar a conocer la implementación del ABP en la asignatura de Resistencia de Materiales de la carrera de Ingeniería Civil en la Universidad de Valparaíso, en tres cohortes/años diferentes como estrategia para evaluar y retroalimentar el logro de los resultados de aprendizaje esperados de las competencias específicas y genéricas, en su primer nivel de dominio. Los resultados muestran que esta metodología contribuyó a evidenciar fortalezas y debilidades en el nivel de logro de las competencias transversales de trabajo en equipo, autorregulación y comunicación. Además, es útil para evidenciar el desarrollo de competencias propias de la ingeniería como la aplicación de herramientas para el análisis de un problema. También se analiza la percepción sobre ganancia de aprendizaje de los estudiantes y se contrasta con los resultados académicos, retroalimentando el nivel de desempeño de los estudiantes con la docencia implementada y así lograr una evidencia para que el comité curricular permanente de la carrera pueda puedan tomar decisiones y llevar a cabo ajustes macro o micro curriculares. En general, se concluye que, en los distintos semestres de implementación del ABP se logran mejoras para la formación de los equipos de trabajo, optimizando así el desempeño académico.

BackgroundCART therapy has produced a paradigm shift in the treatment of relapsing FL patients. Strategies to optimize disease surveillance after these therapies are increasingly necessary. This study explores the potential value of ctDNA monitoring with an innovative signature of personalized trackable mutations.MethodEleven FL patients treated with anti-CD19 CAR T-cell therapy were included. One did not respond and was excluded. Genomic profiling was performed before starting lymphodepleting chemotherapy to identify somatic mutations suitable for LiqBio-MRD monitoring. The dynamics of the baseline mutations (4.5 per patient) were further analyzed on 59 cfDNA follow-up samples. PET/CT examinations were performed on days +90, +180, +365, and every six months until disease progression or death.ResultsAfter a median follow-up of 36 months, all patients achieved a CR as the best response. Two patients progressed. The most frequently mutated genes were CREBBP, KMT2D and EP300. Simultaneous analysis of ctDNA and PET/CT was available for 18 time-points. When PET/CT was positive, two out of four ctDNA samples were LiqBio-MRD negative. These two negative samples corresponded to women with a unique mesenteric mass in two evaluations and never relapsed. Meanwhile, 14 PET/CT negative images were mutation-free based on our LiqBio-MRD analysis (100%). None of the patients had a negative LiqBio-MRD test by day +7. Interestingly, all durably responding patients had undetectable ctDNA at or around three months after infusion. Two patients presented discordant results by PET/CT and ctDNA levels. No progression was confirmed in these cases. All the progressing patients were LiqBio-MRD positive before progression.ConclusionThis is a proof-of-principle for using ctDNA to monitor response to CAR T-cell therapy in FL. Our results confirm that a non-invasive liquid biopsy MRD analysis may correlate with response and could be used to monitor response. Harmonized definitions of ctDNA molecular response and pinpointing the optimal timing for assessing ctDNA responses are necessary for this setting. If using ctDNA analysis, we suggest restricting follow-up PET/CT in CR patients to a clinical suspicion of relapse, to avoid false-positive results.

Treatment options for patients with secondary acute myeloid leukemia (sAML) and AML with myeloid-related changes (AMLMRC) aged 60 to 75 years are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard "3+7" regimens. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60 to 75 years treated with intensive chemotherapy, reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS was 7.6 months (95% confidence interval [CI]: 6.7-8.5) and event-free survival (EFS) 2.7 months (95% CI: 2-3.3), without differences between intensive chemotherapy regimens and AML type. Multivariate analyses identified age ≥70 years, Eastern Cooperative Oncology Group performance status ≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), autologous HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351.

Acute myeloid leukemia has a poor prognosis in older adults, and its management is often unclear due to its underrepresentation in clinical trials. Both overall survival (OS) and health-related quality-of-life (HRQoL) are key outcomes in this population, and patient-reported outcomes may contribute to patient stratification and treatment assignment. This prospective study included 138 consecutive patients treated in daily practice with the currently available non-targeted therapies (intensive chemotherapy [IC], attenuated chemotherapy [AC], hypomethylating agents [HMA], or palliative care [PC]). We evaluated patients’ condition at diagnosis (Life expectancy [Lee Index for Older Adults], Geriatric Assessment in Hematology [GAH scale], HRQoL [EQ-5D-5L questionnaire], and fatigue [fatigue items of the QLQ-C30 scale]), OS, early death (ED), treatment tolerability (TT) and change in HRQoL over 12 months follow-up. The median OS was 7.1 months (IC not reached, AC 5.9, HMA 8.8, and PC 1.0). Poor risk AML category and receiving just palliative care, as well as a higher Lee index score in the patients receiving active therapy, independently predicted a shorter OS. The Lee Index and GAH scale were not useful for predicting TT. The white blood cell count was a valid predictor for ED. Patients’ HRQoL remained stable during follow-up.

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols.

In Mediterranean viticulture, climatic conditions are the main factors that determine grape composition and wine quality. Global warming is causing an increase in the accumulation of soluble solids in grapes, leading to early harvests that result in wines with high alcohol and low phenolic content and colour intensity. The aim of this research was to determine the effectiveness of mixing wines vinified from grapes with different maturation degrees from two consecutive vintages (2018 and 2019) in order to obtain wines with lower pH, lower alcohol content and higher phenolic compound concentration. The wine obtained after mixing wine from unripe grapes (URG) with second harvest (H2) wines significantly improved the physicochemical, chromatic and phenolic characteristics compared to the first harvest (H1) wine. On the other hand, the URGH2 wine had significantly lower alcohol content and pH and higher titratable acidity than the H2 wine. URGH2 maintained its colour intensity in both years and similar values of anthocyanin and tannin in 2018 compared to H2. All the wines were subjected to sensory analysis and the panelists were able to differentiate the wines in a triangle sensory test; the URGH2 wine was preferred in both years. These results show that the blend of unripe grape with wines from technologically mature grapes to reduce alcohol content and improve wine colour could be a useful tool for mitigating the problems caused by global warming in a warm and semiarid Mediterranean climate.

Genetic information has been crucial to understand the pathogenesis of T-cell acute lymphoblastic leukemia (T-ALL) at diagnosis and at relapse, but still nowadays has a limited value in a clinical context. Few genetic markers are associated with the outcome of T-ALL patients, independently of measurable residual disease (MRD) status after therapy. In addition, the prognostic relevance of genetic features may be modulated by the specific treatment used. We analyzed the genetic profile of 145 T-ALL patients by targeted deep sequencing. Genomic information was integrated with the clinicalbiological and survival data of a subset of 116 adult patients enrolled in two consecutive MRD-oriented trials of the Spanish PETHEMA (Programa Español de Tratamientos en Hematología) group. Genetic analysis revealed a mutational profile defined by DNMT3A/ N/KRAS/ MSH2/ U2AF1 gene mutations that identified refractory/resistant patients. Mutations in the DMNT3A gene were also found in the non-leukemic cell fraction of patients with T-ALL, revealing a possible mutational-driven clonal hematopoiesis event to prime T-ALL in elderly. The prognostic impact of this adverse genetic profile was independent of MRD status on day +35 of induction therapy. The combined worse-outcome genetic signature and MRD on day +35 allowed risk stratification of T-ALL into standard or high-risk groups with significantly different 5- year overall survival (OS) of 52% (95% confidence interval: 37-67) and 17% (95% confidence interval: 1-33), respectively. These results confirm the relevance of the tumor genetic profile in predicting patient outcome in adult T-ALL and highlight the need for novel gene-targeted chemotherapeutic schedules to improve the OS of poor-prognosis T-ALL patients.

Acute myeloid leukemia (AML) in the elderly remains a clinical challenge, with a five-year overall survival rate below 10%. The current ELN 2017 genetic risk classification considers cytogenetic and mutational characteristics to stratify fit AML patients into different prognostic groups. However, this classification is not validated for elderly patients treated with a non-intensive approach, and its performance may be suboptimal in this context. Indeed, the transcriptomic landscape of AML in the elderly has been less explored and it might help stratify this group of patients. In the current study, we analyzed the transcriptome of 224 AML patients > 65 years-old at diagnosis treated in the Spanish PETHEMA-FLUGAZA clinical trial in order to identify new prognostic biomarkers in this population. We identified a specific transcriptomic signature for high-risk patients with mutated TP53 or complex karyotype, revealing that low expression of B7H3 gene with high expression of BANP gene identifies a subset of high-risk AML patients surviving more than 12 months. This result was further validated in the BEAT AML cohort. This unique signature highlights the potential of transcriptomics to identify prognostic biomarkers in in elderly AML.

Introduction: The disease-related malnutrition is considered a serious problem since it is strongly related to higher mortality rates, longer hospital stays, and increased costs for medical care. A highly associated risk factor has been the decreased oral intake during the hospital stay; however, the use of oral nutritional supplements allows to heal the malnutrition burden having positive results. Objective: To evaluate the hospital malnutrition risk and the oral nutritional supplements effect for 4 days in anthropometric variables, energy, and protein intake in hospital inpatients. Materials and methods: A cohort study, in a third-level hospital in which within the first 24 hours of the admission, the malnutrition risk was assessed (NRS-2002), the prescribed oral nutritional supplements, its follow-up during a 4-day consumption and its impact on weight, body mass index and muscle strength estimated by dynamometry were analyzed; additionally, the nutritional intake (energy and proteins) was assessed. Results: A total of 290 patients (167W/123M) were assessed, with an average age of 54.7±17.3 years. The malnutrition risk prevalence at hospital admission was 50.3% and from the total patients, 10.3% (n=30) received oral nutritional supplements. After the consumption of oral nutritional supplements, an increased energy consumption was shown in those with a >50% adherence during the 4 days; we found an increased energy adequacy percentage of 73.6 ± 33 to 101 ± 32 (p=0.003) and protein adequacy 75.8 ± 45 to 108 ± 58 (p=0.016), with appropriate tolerance. No differences were documented in anthropometric and arm strength variables. Conclusions: The use of oral nutritional supplements during the hospital stay increases considerably the energy and protein consumption in patients with a >50% adherence with appropriate tolerance.

Mortality rates for COVID-19 have declined over time in the general population, but data in patients with hematologic malignancies are contradictory. We identified independent prognostic factors for COVID-19 severity and survival in unvaccinated patients with hematologic malignancies, compared mortality rates over time and versus non-cancer inpatients, and investigated post COVID-19 condition. Data were analyzed from 1166 consecutive, eligible patients with hematologic malignancies from the population-based HEMATO-MADRID registry, Spain, with COVID-19 prior to vaccination roll-out, stratified into early (February–June 2020; n = 769 (66%)) and later (July 2020–February 2021; n = 397 (34%)) cohorts. Propensity-score matched non-cancer patients were identified from the SEMI-COVID registry. A lower proportion of patients were hospitalized in the later waves (54.2%) compared to the earlier (88.6%), OR 0.15, 95%CI 0.11–0.20. The proportion of hospitalized patients admitted to the ICU was higher in the later cohort (103/215, 47.9%) compared with the early cohort (170/681, 25.0%, 2.77; 2.01–3.82). The reduced 30-day mortality between early and later cohorts of non-cancer inpatients (29.6% vs. 12.6%, OR 0.34; 0.22–0.53) was not paralleled in inpatients with hematologic malignancies (32.3% vs. 34.8%, OR 1.12; 0.81–1.5). Among evaluable patients, 27.3% had post COVID-19 condition. These findings will help inform evidence-based preventive and therapeutic strategies for patients with hematologic malignancies and COVID-19 diagnosis.

Next–Generation Sequencing (NGS) implementation to perform accurate diagnosis in acute myeloid leukemia (AML) represents a major challenge for molecular laboratories in terms of specialization, standardization, costs and logistical support. In this context, the PETHEMA cooperative group has established the first nationwide diagnostic network of seven reference laboratories to provide standardized NGS studies for AML patients. Cross–validation (CV) rounds are regularly performed to ensure the quality of NGS studies and to keep updated clinically relevant genes recommended for NGS study. The molecular characterization of 2856 samples (1631 derived from the NGS–AML project; NCT03311815) with standardized NGS of consensus genes (ABL1, ASXL1, BRAF, CALR, CBL, CEBPA, CSF3R, DNMT3A, ETV6, EZH2, FLT3, GATA2, HRAS, IDH1, IDH2, JAK2, KIT, KRAS, MPL, NPM1, NRAS, PTPN11, RUNX1, SETBP1, SF3B1, SRSF2, TET2, TP53, U2AF1 and WT1) showed 97% of patients having at least one mutation. The mutational profile was highly variable according to moment of disease, age and sex, and several co–occurring and exclusion relations were detected. Molecular testing based on NGS allowed accurate diagnosis and reliable prognosis stratification of 954 AML patients according to new genomic classification proposed by Tazi et al. Novel molecular subgroups, such as mutated WT1 and mutations in at least two myelodysplasia–related genes, have been associated with an adverse prognosis in our cohort. In this way, the PETHEMA cooperative group efficiently provides an extensive molecular characterization for AML diagnosis and risk stratification, ensuring technical quality and equity in access to NGS studies.

Abstract Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. Methods In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. Results Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17–10.1 vs 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). Conclusions In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.

Abstract Background Pediatric‐based or ‐inspired trials have improved the prognosis of adolescents and young adults (AYA) with Philadelphia chromosome‐negative (Ph‐neg) acute lymphoblastic leukemia (ALL). Methods This study reports the results of treatment of the ALLRE08 trial, a full pediatric trial for AYA aged 15‐30 years with standard‐risk (SR) ALL. Results From 2008 to 2018, 89 patients (38 adolescents [15‐18 years] and 51 young adults [YA, 19‐30 years], median age: 20 [15‐29] years) were enrolled in the ALLRE08 trial. The complete response (CR) was 95%. Twenty‐two patients were transferred to a high‐risk (HR) protocol because of poor marrow response on day 14 (n = 20) or high‐level of end‐induction minimal residual response (MRD ≥ 0.25%, n = 2). Cumulative incidence of relapse (CIR) at 5 years was 35% (95%CI: 23%‐47%), with significant differences between adolescents and YA: 13% (4%‐28%) vs 52% (34%‐67%), P = .012. No treatment‐related mortality was observed in 66/66 patients following the ALLRE08 trial vs 3/23 patients moved to a HR trial. The estimated 5‐year overall survival (OS) was 74% (95%CI: 63%‐85%), with significantly higher rates for adolescents vs YA: 87% (95%CI: 74%‐100%) vs 63% (46%‐80%), P = .021. Although CIR or OS were lower in patients who were transferred to a HR trial, the differences were not statistically significant (CIR: 34% [21%‐47%] vs 37% [14%‐61%]; OS: 78% [66%‐90%] vs 61% [31%;91%]). Conclusion A full pediatric trial is feasible and effective for AYA with Ph‐neg, SR‐ALL, with better results for adolescents than for YA. Outcome of patients with poor early response rescued with a HR trial was not significantly inferior.

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case–control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March–July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3–5.9), occupational risk (OR: 2.9; 95%CI: 1.8–4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2–2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09–0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution.

Ustekinumab has shown efficacy in Crohn’s Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients’ data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index ≤ 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission.

Xanthophyllomyces dendrorhous is a natural source of astaxanthin and mycosporines. This yeast has been isolated from high and cold mountainous regions around the world, and the production of these secondary metabolites may be a survival strategy against the stress conditions present in its environment. Biosynthesis of astaxanthin is regulated by catabolic repression through the interaction between MIG1 and corepressor CYC8–TUP1. To evaluate the role of the stress-associated transcription factors SKN7, ROX1, and YAP6, we employed an omic and phenotypic approach. Null mutants were constructed and grown in two fermentable carbon sources. The yeast proteome and transcriptome were quantified by iTRAQ and RNA-seq, respectively. The total carotenoid, sterol, and mycosporine contents were determined and compared to the wild-type strain. Each mutant strain showed significant metabolic changes compared to the wild type that were correlated to its phenotype. In a metabolic context, the principal pathways affected were glycolysis/gluconeogenesis, the pentose phosphate (PP) pathway, and the citrate (TCA) cycle. Additionally, fatty acid synthesis was affected. The absence of ROX1 generated a significant decline in carotenoid production. In contrast, a rise in mycosporine and sterol synthesis was shown in the absence of the transcription factors SKN7 and YAP6, respectively.

La Formación Profesional es esencial para afrontar las grandes transformaciones del siglo XXI. La investigación sobre la misma permite responder a los principales desafíos de esta vertiente educativa. Es el trabajo realizado por diez analistas de universidades españolas que han tratado de identificar los factores que frenan o propician la investigación sobre Formación Profesional en su contexto. La metodología empleada ha sido participativa e intencional con un carácter grupal, crítico, procesual y constructivo. Mediante la técnica DAFO se delimitan de forma consensuada 12 Retos esenciales a abordar. A través de la técnica CAME se establecen una serie de estrategias de acción para cada reto que han permitido corregir, afrontar, mantener y explotar el mejor desarrollo posible de esta línea de investigación. Se concluye y recomienda la configuración progresiva e inclusiva de un ecosistema de Investigación sobre FP en España (IFPE), extensible en buena parte a otros países con cultura similar.

The current society inserted in a VUCA world (volatile, uncertain, complex and ambiguous) has produced vertiginous changes in relation to breastfeeding. That is why we consider it necessary to analyze the knowledge and scientific production carried out to date on this discipline. From this concern, this research emerges as an interdisciplinary study that aims to give priority to the protection, promotion and support of breastfeeding. The purpose is to investigate the growth and distribution of scientific documents through their analysis and evaluation, in order to gather the scientific production of researchers on breastfeeding. To this end, a sample of 155 Doctoral Theses published in Spanish Universities is used, with the common denominator of the word breastfeeding, in the period that goes from 1980 to 2015. The methodology used is mixed, with qualitative data analysis, framed within a retrospective and descriptive analysis, as well as a quantitative analysis through bibliometric indicators. The aim is to offer a solid and reliable set of systematic, empirical and critical research processes and results, in order to present information on current and future research and innovation trends.

This retrospective study investigated outcomes of 404 patients with relapsed/refractory (R/R) FMS-like tyrosine kinase 3 (FLT3)-internal tandem duplication (ITD) acute myeloid leukemia (AML) enrolled in the PETHEMA registry, pre-approval of tyrosine kinase inhibitors. Most patients (63%) had received first-line intensive therapy with 3 + 7. Subsequently, patients received salvage with intensive therapy (n = 261), non-intensive therapy (n = 63) or supportive care only (n = 80). Active salvage therapy (i.e., intensive or non-intensive therapy) resulted in a complete remission (CR) or CR without hematological recovery (CRi) rate of 42%. More patients achieved a CR/CRi with intensive (48%) compared with non-intensive (19%) salvage therapy (p < 0.001). In the overall population, median overall survival (OS) was 5.5 months; 1- and 5-year OS rates were 25% and 7%. OS was significantly (p < 0.001) prolonged with intensive or non-intensive salvage therapy compared with supportive therapy, and in those achieving CR/CRi versus no responders. Of 280 evaluable patients, 61 (22%) had an allogeneic stem-cell transplant after they had achieved CR/CRi. In conclusion, in this large cohort study, salvage treatment approaches for patients with FLT3-ITD mutated R/R AML were heterogeneous. Median OS was poor with both non-intensive and intensive salvage therapy, with best long-term outcomes obtained in patients who achieved CR/CRi and subsequently underwent allogeneic stem-cell transplant.

This essay analyzes Richard Powers’s The Overstory (2018), a novel that ostensibly demands an eco-critical reading, under the lens of neurodiversity. Focusing on the idiosyncrasies of sensory perception in autism, the essay explores the atypical engagement with the more-than-human that neurodiversity (and specifically autism) fosters—a kind of engagement that deeply destabilizes neuro-normative, human-centered subjectivity, opening up to more egalitarian ways of relation with the environment. In a novel populated by neurodivergent characters with a keen ecological sensibility, Powers comes close to imagining this kind of non-hierarchical connection with the natural world. The essay explores how neurodiversity works in the novel at a characterological, thematic, and structural level, functioning as a bridge between human and non-human scales. In this way, neurodiversity finely glosses and articulates the kind of animistic, environmental message that Powers instils in his Pulitzer prize winning novel.

El propósito general de este artículo es dar a conocer el proceso de adaptación y validación del instrumento de recolección de información del estudio Percepción de estudiantes y docentes sobre las prácticas evaluativas como competencia profesional del profesorado en tres títulos de la Universidad El Bosque, Bogotá, Colombia PREVAPREDU. En este sentido, la adaptación se realizó a partir del nivel de formación y del enfoque pedagógico. Luego, buscó determinar la validez de contenido, establecer la validez de constructo del instrumento y señalar la estabilidad y/o fiabilidad del mismo. Esta investigación se desarrolló bajo la orientación metodológica de un estudio mixto convergente según Creswell (2012), con alcance no experimental, descriptivo de corte transversal. Es necesario advertir que la recolección de la información se realizó en un solo momento por cada unidad de análisis. Se utilizaron dos estrategias: análisis de los datos, que se aplicaron a una muestra de la población y revisión del instrumento por once expertos, quienes debían valorarlo según su claridad, pertinencia, relevancia y exclusividad, en una escala de cuatro niveles, sobre los componentes que constituyen las bases conceptuales del instrumento a saber, concepción de evaluación del aprendizaje, características de la evaluación, actores del proceso evaluativo, contenido de la evaluación, momentos para la evaluación, procedimientos del proceso evaluativo, técnicas e instrumentos de evaluación, usos de la evaluación del aprendizaje y formas de retroalimentación y por último, competencias evaluativas. El Alpha de Cronbach fue de 0,860 en los docentes y 0,973 en los estudiantes, resultado óptimo para la consistencia interna; respecto a la validez de contenido el resultado que se obtuvo en la W de Kendall es de 0,654 para los docentes y de 0,785 para los estudiantes los dos valores indican que hay una tendencia general, de acuerdo en el criterio de los jueces; en cuanto a la validez de constructo se aplicó el análisis factorial exploratorio y el confirmatorio: en el exploratorio Kaiser Meyer Olkin (kmo) se obtuvo para docentes 0,714 y para estudiantes 0,923, valores cercanos a 1, considerados óptimos, el confirmatorio permitió la reubicación de los ítems en cada una de las dimensiones, mediante la matriz de componentes rotados, se excluyeron valores inferiores a 0,500 por no ser significativos. En esta medida, PREVAPREDU se piensa como un recurso adaptado y validado para dar una mirada de 360° grados a las prácticas evaluativas de los docentes en el ámbito de la educación superior.

Next-generation sequencing (NGS) has recently been introduced to efficiently and simultaneously detect genetic variations in acute myeloid leukemia (AML). However, its implementation in the clinical routine raises new challenges focused on the diversity of assays and variant reporting criteria. In order to overcome this challenge, the PETHEMA group established a nationwide network of reference laboratories aimed to deliver molecular results in the clinics. We report the technical cross-validation results for NGS panel genes during the standardization process and the clinical validation in 823 samples of 751 patients with newly diagnosed or refractory/relapse AML. Two cross-validation rounds were performed in seven nationwide reference laboratories in order to reach a consensus regarding quality metrics criteria and variant reporting. In the pre-standardization cross-validation round, an overall concordance of 60.98% was obtained with a great variability in selected genes and conditions across laboratories. After consensus of relevant genes and optimization of quality parameters the overall concordance rose to 85.57% in the second cross-validation round. We show that a diagnostic network with harmonized NGS analysis and reporting in seven experienced laboratories is feasible in the context of a scientific group. This cooperative nationwide strategy provides advanced molecular diagnostic for AML patients of the PETHEMA group (clinicaltrials gov. Identifier: NCT03311815).

We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March–July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8–27 and 4.5, 95% CI: 1.3–15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3–11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD.

Early identification of severe viral pneumonia in influenza virus A (H1N1pdm09) patients is extremely important for prompt admission to the ICU. The objective is to evaluate the usefulness of MR-proadrenomedullin (MR-proADM) compared to C reactive protein (CRP), procalcitonin (PCT), and ferritin in the prognosis of influenza A pneumonia. This prospective, observational, multicenter study included one hundred thirteen patients with confirmed influenza virus A (H1N1pdm09) admitted to an Emergency Department and ICUs of six hospitals in Spain. Measurements and Main Results: one-hundred thirteen patients with confirmed influenza virus A (H1N1pdm09) were enrolled. Seventy-five subjects (mortality 29.3%) with severe pneumonia caused by influenza A H1N1pdm09 virus (H1N1vIPN) were compared with 38 controls (CG).The median MR-proADM levels at hospital admission were 1.2 nmol/L (IQR (0.8–2.6) vs. 0.5 nmol/L (IQR 0.2–0.9) in the CG (p = 0.01), and PCT levels were 0.43 μg/L (IQR 0.2–1.2) in the H1N1vIPN group and 0.1 μg/L (IQR 0.1–0.2) in the CG (p < 0.01). CRP levels at admission were 15.5 mg/dL(IQR 9.2–24.9) in H1N1vIPN and 8.6 mg/dL(IQR 3–17.3) in the CG (p < 0.01). Ferritin levels at admission were 558.1 ng/mL(IQR 180–1880) in H1N1vIPN and 167.7 ng/mL(IQR 34.8–292.9) in the CG (p < 0.01). A breakpoint for hospital admission of MR-proADM of 1.1 nmol/L showed a sensitivity of 55% and a specificity of 90% (AUC-ROC0.822). Non-survivors showed higher MR-proADM levels: median of 2.5 nmol/L vs. 0.9 nmol/L among survivors (p < 0.01). PCT, CRP, and ferritin levels also showed significant differences in predicting mortality. The MR-proADM AUC-ROC for mortality was 0.853 (p < 0.01). In a Cox proportional hazards model, MR-proADM levels > 1.2 nmol/L at hospital admission were significant predictive factors for ICU and 90-day mortality (HR: 1.3). Conclusions: the initial MR-proADM, ferritin, CRP, and PCT levels effectively determine adverse outcomes and risk of ICU admission and mortality in patients with influenza virus pneumonia. MR-proADM has the highest potency for survival prediction.

Corn (Zea mays L.) is not only an important food source, but also has numerous uses, including for biofuels, fillers for cosmetics, glues, and so on. The amount of corn grown in the U.S. has significantly increased since the 1960’s and with it, the demand for synthetic fertilizers and pesticides/fungicides to enhance its production. However, the downside of the continuous use of these products, especially N and P fertilizers, has been an increase in N2O emissions and other greenhouse gases into the atmosphere as well as run-off into waterways that fuel pollution and algal blooms. These approaches to agriculture, especially if exacerbated by climate change, will result in decreased soil health as well as human health. We searched for microbes from arid, native environments that are not being used for agriculture because we reasoned that indigenous microbes from such soils could promote plant growth and help restore degraded soils. Employing cultivation-dependent methods to isolate bacteria from the Negev Desert in Israel, we tested the effects of several microbial isolates on corn in both greenhouse and small field studies. One strain, Dietzia cinnamea 55, originally identified as Planomicrobium chinense, significantly enhanced corn growth over the uninoculated control in both greenhouse and outside garden experiments. We sequenced and analyzed the genome of this bacterial species to elucidate some of the mechanisms whereby D. cinnamea 55 promoted plant growth. In addition, to ensure the biosafety of this previously unknown plant growth promoting bacterial (PGPB) strain as a potential bioinoculant, we tested the survival and growth of Caenorhabditis elegans and Galleria mellonella (two animal virulence tests) as well as plants in response to D. cinnamea 55 inoculation. We also looked for genes for potential virulence determinants as well as for growth promotion.

Entre 1885 y 1930, luego de las campañas militares contra los pueblos indígenas, el norte de la actual provincia de La Pampa comenzó a ser ocupado por instalaciones relacionadas con la explotación rural: estancias con sistema arrendatario, colonias, poblados y asentamientos comerciales. Desde 2008 nos encontramos estudiando esta problemática que se enmarca dentro de la denominada arqueología rural. En este trabajo se presentarán los avances preliminares con respecto al abordaje del sitio “Casa de Negocios La Estrella” (1884-1946) ubicado en las proximidades de la ciudad de Parera (Departamento de Rancul, provincia de La Pampa). Dicho sitio se trata de una pulpería o boliche que se hallaba en una intersección de caminos que lo vinculaba con diversos tipos de asentamientos (estancias, puestos y otros almacenes y casas de negocios) conformando parte constitutivo del paisaje rural reciente. En la campaña 2018 se realizó la determinación de la extensión del sitio, se recolectaron sistemáticamente los materiales de superficie y se realizaron 14 sondeos. Se comenzará con el análisis de mapas históricos a través del GIS, luego se explicitará la metodología de campo utilizada y finalmente se describirán los procesos de formación de sitio que afectaron a los materiales recuperados en los sondeos.

There is some controversy about the value of fetal MRI in prenatal diagnosis, and most of the studies examine its accuracy in central nervous system (CNS) pathology. The objective of this retrospective study was to assess the diagnostic accuracy and usefulness of fetal MRI in the prenatal diagnosis of central nervous system (CNS) pathology and non-CNS pathology. Patients referred to the Radiology Department between 2007 and 2018 for a fetal MRI after detection of an anomaly in the fetal ultrasound, a high-risk pregnancy, or an inconclusive fetal ultrasound (n = 623) were included in the study. Postnatal diagnosis was used to assess the diagnostic accuracy of MRI. Fetal MRI was considered to provide additional information over fetal ultrasound when findings of the fetal MRI were not detected in the fetal ultrasound or when established a pathological condition that was not detected in the fetal ultrasound. Fetal MRI provided useful information for the perinatal management and prognosis over fetal ultrasound when findings of the fetal MRI changed the postnatal prognosis, leaded to the decision to legally terminate the pregnancy, changed prenatal or postnatal follow-up, or helped in the planning of prenatal or postnatal treatment. Fetal MRI offered an accurate diagnosis in 97% of cases (compared to 90.4% of fetal ultrasound; p

Una de las exigencias que plantea la sociedad a la universidad es potenciar y facilitar la inserción socio-laboral de los futuros egresados. Conscientes de esta realidad, este trabajo pretende elaborar un instrumento que permita calibrar la adecuación entre la formación universitaria y los requerimientos competencia- les del mercado laboral a través del estudio de la formación en Competencias Transversales (CT) en las aulas universitarias. Para ello, se plantea analizar las características psicométricas del cuestionario CECTGRA diseñado ad hoc y dirigido a valorar el desarrollo y dominio de las CT, así como su relevancia para el desarrollo profesional del egresado. Tras el diseño y aplicación del instrumento de recogida de información a una muestra de 1062 estudiantes de último año de Grado de las distintas ramas de conocimiento, se analiza la ®abilidad y se obtienen las evidencias de validez basadas en el contenido y en la estructura interna del cuestionario mediante el método de agregados individua- les y los Modelos de Ecuaciones Estructurales con la aplicación del programa AMOS. Los análisis muestran unos resultados satisfactorios en relación a la ®abilidad de la escala global (desarrollo, α =.927; dominio, α =.881, y relevancia, α =.917) y de las subescalas resultantes (competencias instrumentales, α =.785, α =.718 y α =.819; competencias personales, α =.825, α =.774 y α =.743; compe-tencias sistémicas, α =.899, α =.881 y α =.864 respectivamente para desarrollo, dominio y relevancia). Asimismo, una vez obtenidas las evidencias de validez sobre la estructura interna del cuestionario a través del Análisis Factorial Con- ®rmatorio (CFI=.947; IFI=.947; NFI=.938 y RMSEA=.072) se constata que se trata de un instrumento que reúne las especi®caciones técnicas exigidas para ser considerado una herramienta válida y ®able.

Canola (Brassica napus L. var. oleracea) is the third most common oil-producing crop worldwide after palm and soybean. Canola cultivation requires the use of chemical fertilizers, but the amount required can be reduced by applying plant growth-promoting bacteria (PGPB). Among PGPB, endophytic bacteria have certain advantages as biofertilizers, but canola endophytic bacteria have rarely been studied. In this work, we identified a collection of bacterial endophytes isolated from canola roots using MALDI-TOF MS, a technique that is still rarely used for the identification of such bacteria, and rrs gene sequencing, a methodology that is commonly used to identify canola endophytes. The results demonstrated that some bacterial isolates from canola roots belonged to the genera Bacillus, Neobacillus, Peribacillus (Pe.), and Terribacillus, but most isolates belonged to the genera Paenibacillus (P.) and Pseudomonas (Ps.). Inoculation of these isolates indicated that several of them could efficiently promote canola seedling growth in hydroponic conditions. These results were then confirmed in a microcosm experiment using agricultural soil, which demonstrated that several isolates of Pseudomonas thivervalensis, Paenibacillus amylolyticus, Paenibacillus polymyxa, Paenibacillus sp. (Paenibacillus glucanolyticus/Paenibacillus lautus group), and Peribacillus simplex (previously Bacillus simplex) could efficiently promote canola shoot growth under greenhouse conditions. Among them, the isolates of Paenibacillus and Peribacillus were the most promising biofertilizers for canola crops as they are sporulated rods, which is an advantageous trait when formulating biofertilizers.

Chitin is an important component of the exteriors of insects and fungi. Upon degradation of chitin by a number of organisms, severe damage and even death may occur in pathogens and pests whose external surfaces contain this polymer. Currently, chemical fungicides and insecticides are the major means of controlling these disease-causing agents. However, due to the potential harm that these chemicals cause to the environment and to human and animal health, new strategies are being developed to replace or reduce the use of fungal- and pest-killing compounds in agriculture. In this context, chitinolytic microorganisms are likely to play an important role as biocontrol agents and pathogen antagonists and may also function in the control of postharvest rot. In this review, we discuss the literature concerning chitin and the basic knowledge of chitin-degrading enzymes, and also describe the biocontrol effects of chitinolytic microorganisms and their potential use as more sustainable pesticides and fungicides in the field.

Abstract After a forest wildfire, the microbial communities have a transient alteration in their composition. The role of the soil microbial community in the recovery of an ecosystem following such an event remains poorly understood. Thus, it is necessary to understand the plant-microbe interactions that occur in burned soils. By high-throughput sequencing, we identified the main bacterial taxa of burnt holm-oak rhizosphere, then we obtained an isolate collection of the most abundant genus and its growth promoting activities were characterised. 16S rRNA amplicon sequencing showed that the genus Arthrobacter comprised more than 21% of the total community. 55 Arthrobacter strains were isolated and characterized using RAPDs and sequencing of the almost complete 16S rRNA gene. Our results indicate that isolated Arthrobacter strains present a very high genetic diversity, and they could play an important ecological role in interaction with the host plant by enhancing aerial growth. Most of the selected strains exhibited a great ability to degrade organic polymers in vitro as well as possibly presenting a direct mechanism for plant growth promotion. All the above data suggests that Arthrobacter can be considered as an excellent PGP rhizobacterium that may play an important role in the recovery of burned holm-oak forests.

For decades, rhizobia were thought to be the only nitrogen-fixing inhabitants of legume nodules, and biases in culture techniques prolonged this belief. However, other bacteria, which are not typical rhizobia, are often detected within nodules obtained from soil, thus revealing the existence of a phytomicrobiome where the interaction among the individuals is not only complex, but also likely to affect the behavior and fitness of the host plant. Many of these nonrhizobial bacteria are nitrogen fixers, and some also induce nitrogen-fixing nodules on legume roots. Even more striking is the incredibly diverse population of bacteria residing within nodules that elicit neither nodulation nor nitrogen fixation. Yet, this community exists within the nodule, albeit clearly out-numbered by nitrogen-fixing rhizobia. Few studies of the function of these nodule-associated bacteria in nodules have been performed, and to date, it is not known whether their presence in nodules is biologically important or not. Do they confer any benefits to the Rhizobium-legume nitrogen-fixing symbiosis, or are they parasites/saprophytes, contaminants, or commensals? In this review, we highlight the lesser-known bacteria that dwell within nitrogen-fixing nodules and discuss their possible role in this enclosed community as well as any likely benefits to the host plant or to the rhizobial inhabitants of the nodule. Although many of these nodule inhabitants are not capable of nitrogen fixation, they have the potential to enhance legume survival especially under conditions of environmental stress. This knowledge will be useful in defining strategies to employ these bacteria as bioinoculants by themselves or combined with rhizobia. Such an approach will enhance rhizobial performance or persistence as well as decrease the usage of chemical fertilizers and pesticides.