Search

This paper explores the education of prospective teachers with regard to the Theory of Didactical Situations when they engage in lesson study. We particularly focus on studying how a lesson study process oriented towards the Theory of Didactical Situations contributes to increasing prospective teachers' self-efficacy to plan and teach lessons based on such theory, reducing the gap between theory and practice. Prior to the study, we will discuss how the theoretical postulates assumed in lesson study affect crucial aspects of the process. The study is implemented with 47 prospective early childhood education teachers. We also consider another group of 47 prospective teachers that were engaged in practicum at the time the lesson study process took place. Using a quasi-experimental methodology based on a questionnaire developed ad hoc that captures the particularities of the didactic paradigm assumed, the results of our study show that both lesson study and practicum lead to a statistically significant increase in future teachers' self-efficacy to plan and teach lessons in line with the paradigm assumed. However, size effect measures show that the increase observed in the lesson study group is significantly higher, which supports the benefits of lesson study in initial teacher education. We discuss what the features of lesson study are that could be related to this increase. Finally, we sketch new lines of research connected with the benefits of lesson study versus other teacher education experiences like practicum, as well as with links between self-efficacy and knowledge growth in lesson study.

Abstract Background Some evidence suggests that fluid resuscitation with lactated Ringer’s solution (LR) may have an anti-inflammatory effect on acute pancreatitis (AP) when compared to normal saline (NS) and may be associated with a decrease in severity, but existing single-center randomized controlled trials showed conflicting results. The WATERLAND trial aims to investigate the efficacy and safety of fluid resuscitation using LR compared to NS in patients with AP. Methods The WATERLAND trial is an international multicenter, open-label, parallel-group, randomized, controlled, superiority trial. Patients will be randomly assigned in a 1:1 ratio to receive LR versus NS-based fluid resuscitation for at least 48 h. The primary outcome will be moderately severe or severe AP, according to the revision of the Atlanta classification. The secondary objectives of the WATERLAND trial are to determine the effect of LR versus NS fluid resuscitation on several efficacy and safety outcomes in patients with AP. A total sample of 720 patients, 360 in the LR group and 360 in the NS group, will achieve 90% power to detect a difference between the group proportions of 10%, assuming that the frequency of moderately severe or severe AP in the LR group will be 17%. A loss to follow-up of 10% of patients is expected, so the total sample size will be 396 patients in each treatment arm (792 patients overall). The test statistic used is the two-sided Z test with pooled variance set at a 0.05 significance level. Discussion The WATERLAND study aims to improve the early management of AP. Fluid resuscitation is an inexpensive treatment available in any hospital center worldwide. If a better evolution of pancreatitis is demonstrated in one of the treatment arms, it would have important repercussions in the management of this frequent disease. Trial registration ClinicalTrials.gov, NCT05781243. Registration date on January 4, 2023. EudraCT number 2023–000010-18, first posted March 23, 2023.

The Festival of the Patios of Cordoba, declared an Intangible Cultural Heritage (ICH) by UNESCO in 2012, serves as an emblematic case of how this designation acts as a tourist brand, attracting a greater number of visitors and granting a competitive advantage to the city’s tourist market. This research is focused on analyzing the differences and similarities in the satisfaction, lived experience and behavioral intention of tourists according to their sociodemographic profile during the 2022 edition of the Patios Festival. The study’s main objective is to understand the sociodemographic profile of the tourist who visits this event and if there are features of this profile that influence the satisfaction and lived experience with the event. Using a quantitative methodological approach, field work was carried out during the Fiesta de los Patios of Cordoba (Spain) in its 2022 edition, which took place between 3 and 15 May 2022, obtaining 383 valid surveys. The results reveal differences in the perception and satisfaction of the experience depending on the sociodemographic profile of the visitors. These findings highlight the need to adapt the tourism offerings to improve the visitor experience and also contribute to the scarcity of studies on ICH to help tourism managers formulate strategies that maximize the cultural and economic benefits of these Word Heritage inscriptions.

Abstract Background Gene editing therapies in development for correcting out-of-frame DMD mutations in Duchenne muscular dystrophy aim to replicate benign spontaneous deletions. Deletion of 45–55 DMD exons (del45–55) was described in asymptomatic subjects, but recently serious skeletal and cardiac complications have been reported. Uncovering why a single mutation like del45–55 is able to induce diverse phenotypes and grades of severity may impact the strategies of emerging therapies. Cellular models are essential for this purpose, but their availability is compromised by scarce muscle biopsies. Methods We introduced, as a proof-of-concept, using CRISPR-Cas9 edition, a del45–55 mimicking the intronic breakpoints harboured by a subset of patients of this form of dystrophinopathy (designing specific gRNAs), into a Duchenne patient’s cell line. The edited cell line was characterized evaluating the dystrophin expression and the myogenic status. Results Dystrophin expression was restored, and the myogenic defects were ameliorated in the edited myoblasts harbouring a specific del45–55. Besides confirming the potential of CRISPR-Cas9 to create tailored mutations (despite the low cleavage efficiency of our gRNAs) as a useful approach to generate in vitro models, we also generated an immortalized myoblast line derived from a patient with a specific del45–55. Conclusions Overall, we provide helpful resources to deepen into unknown factors responsible for DMD-pathophysiology.

The question of language in school has an educational dimension of considerable social interest in Spain since a strong process of immersion in regional languages might be affecting students’ performance depending on their linguistic and socio-cultural background. In this context, the paper’s aim is to analyse the relations between economic, social, and cultural status (ESCS); the percentage of students who speak a different language at school than at home (language) and school performance in PISA (performance); and in particular to measure the predictive power of the second variable with respect to the third, from a territorial perspective. A methodology was developed based on bivariate linear regression analysis and structural equation modelling, and was applied to data regarding these three variables from the PISA 2015 and PISA 2022 databases. These secondary analyses have confirmed: (a) the importance of the predictive power of ESCS on performance consistently in both 2015 and 2022; (b) the intensification of the association between the two variables in that period; and (c) the emergence of a moderate but significant association of the language variable as a predictor of Performance at the territorial level. The impact of regional ESCS differences on performance increased significantly between 2015 and 2022, which is compatible with an increase in other territorial divides described in the literature. Moreover, the strong linguistic immersion models display significant differences between territories in terms of performance. For example, for this reason alone, Catalonia’s delay compared to Madrid is approximately one school year.

Resumen: Introducción: Los traumatismos periféricos son una causa muy frecuente de consulta en las urgencias pediátricas, pero apenas se han publicado estudios que describan las características de estos pacientes. Material y métodos: Se realiza un estudio descriptivo retrospectivo mediante revisión de formularios informatizados de urgencias pediátricas durante los meses de enero y febrero de 2020. Objetivo: Conocer las características de la patología traumática pediátrica de nuestra área y detectar posibles puntos de mejora. Resultados: Se atendieron 714 traumatismos periféricos, lo que supone 9,5% de las consultas totales. De los pacientes presentados, 52,7% fueron escolares (6 a 11 años). Las localizaciones más frecuentes fueron el tobillo (27,5%) y los dedos de la mano (17,2%). Se detectó fractura en 6,7% de los casos. En 78,6% de los pacientes se solicitó radiografía, siendo patológica 9,6% de las mismas. La mitad de las radiografías se solicitaron por traumatismo en el tobillo o dedos de la mano. Se realizó interconsulta a traumatología en 16,4% de los pacientes, sobre todo en traumatismos de codo y rodilla, y el tratamiento más empleado fueron las medidas generales (49%) y el vendaje (29,4%). Conclusiones: Los traumatismos periféricos son muy habituales y, en general, banales. Se solicita un gran número de radiografías con una rentabilidad muy baja, por lo que parece necesario establecer nuevos protocolos que permitan reducir el número de peticiones. Mejorar la formación respecto a los traumatismos de codo y rodilla podría mejorar la autonomía de los pediatras respecto a este tipo de lesiones, más complejas. Abstract: Introduction: Peripheral trauma is a very frequent cause of consultation in paediatric emergency departments but few studies have been published describing the characteristics of these patients. Material and methods: We performed a retrospective descriptive study by reviewing computerised emergency department forms during January and February 2020. Objective: To describe the characteristics of traumatic injuries in our area and to detect possible areas for improvement. Results: A total of 714 peripheral trauma cases were attended, which represents 9.5% of the total consultations. A total of 52.7% were schoolchildren (6–11 years). The most frequent locations were the ankle (27.5%) and fingers (17.2%). Fracture was detected in 6.7% of cases. Radiographs were requested in 78.6% of the patients, with pathological findings in 9.6% of them. Half of the X-rays were requested due to ankle or finger trauma. Referral to traumatology was made in 16.4% of patients, mainly for elbow and knee trauma, and the most commonly used treatment was general measures (49%) and bandaging (29.4%). Conclusions: Peripheral trauma is very common and, in general, banal. A large number of X-rays are requested with a very low yield, so it seems necessary to establish new protocols to reduce the number of requests. Improving training in elbow and knee trauma could improve paediatricians’ autonomy in dealing with these more complex injuries.

Abstract Background Schizophrenia is a severe neuropsychiatric disorder characterized by altered perception, mood, and behavior that profoundly impacts patients and society despite its relatively low prevalence. Sex-based differences have been described in schizophrenia epidemiology, symptomatology and outcomes. Different studies explored the impact of schizophrenia in the brain transcriptome, however we lack a consensus transcriptomic profile that considers sex and differentiates specific cerebral regions. Methods We performed a systematic review on bulk RNA-sequencing studies of post-mortem brain samples. Then, we fulfilled differential expression analysis on each study and summarized their results with regions-specific meta-analyses (prefrontal cortex and hippocampus) and a global all-studies meta-analysis. Finally, we used the consensus transcriptomic profiles to functionally characterize the impact of schizophrenia in males and females by protein-protein interaction networks, enriched biological processes and dysregulated transcription factors. Results We discovered the sex-based dysregulation of 265 genes in the prefrontal cortex, 1.414 genes in the hippocampus and 66 genes in the all-studies meta-analyses. The functional characterization of these gene sets unveiled increased processes related to immune response functions in the prefrontal cortex in male and the hippocampus in female schizophrenia patients and the overexpression of genes related to neurotransmission and synapses in the prefrontal cortex of female schizophrenia patients. Considering a meta-analysis of all brain regions available, we encountered the relative overexpression of genes related to synaptic plasticity and transmission in females and the overexpression of genes involved in organizing genetic information and protein folding in male schizophrenia patients. The protein-protein interaction networks and transcription factors activity analyses supported these sex-based profiles. Conclusions Our results report multiple sex-based transcriptomic alterations in specific brain regions of schizophrenia patients, which provides new insight into the role of sex in schizophrenia. Moreover, we unveil a partial overlapping of inflammatory processes in the prefrontal cortex of males and the hippocampus of females.

Abstract Background There exists consistent empirical evidence in the literature pointing out ample heterogeneity in terms of the clinical evolution of patients with COVID-19. The identification of specific phenotypes underlying in the population might contribute towards a better understanding and characterization of the different courses of the disease. The aim of this study was to identify distinct clinical phenotypes among hospitalized patients with SARS-CoV-2 pneumonia using machine learning clustering, and to study their association with subsequent clinical outcomes as severity and mortality. Methods Multicentric observational, prospective, longitudinal, cohort study conducted in four hospitals in Spain. We included adult patients admitted for in-hospital stay due to SARS-CoV-2 pneumonia. We collected a broad spectrum of variables to describe exhaustively each case: patient demographics, comorbidities, symptoms, physiological status, baseline examinations (blood analytics, arterial gas test), etc. For the development and internal validation of the clustering/phenotype models, the dataset was split into training and test sets (50% each). We proposed a sequence of machine learning stages: feature scaling, missing data imputation, reduction of data dimensionality via Kernel Principal Component Analysis (KPCA), and clustering with the k-means algorithm. The optimal cluster model parameters –including k, the number of phenotypes– were chosen automatically, by maximizing the average Silhouette score across the training set. Results We enrolled 1548 patients, each of them characterized by 92 clinical attributes (d=109 features after variable encoding). Our clustering algorithm identified k=3 distinct phenotypes and 18 strongly informative variables: Phenotype A (788 cases [50.9% prevalence] – age $$\sim$$ ∼ 57, Charlson comorbidity $$\sim$$ ∼ 1, pneumonia CURB-65 score $$\sim$$ ∼ 0 to 1, respiratory rate at admission $$\sim$$ ∼ 18 min-1, FiO2 $$\sim$$ ∼ 21%, C-reactive protein CRP $$\sim$$ ∼ 49.5 mg/dL [median within cluster]); phenotype B (620 cases [40.0%] – age $$\sim$$ ∼ 75, Charlson $$\sim$$ ∼ 5, CURB-65 $$\sim$$ ∼ 1 to 2, respiration $$\sim$$ ∼ 20 min-1, FiO2 $$\sim$$ ∼ 21%, CRP $$\sim$$ ∼ 101.5 mg/dL); and phenotype C (140 cases [9.0%] – age $$\sim$$ ∼ 71, Charlson $$\sim$$ ∼ 4, CURB-65 $$\sim$$ ∼ 0 to 2, respiration $$\sim$$ ∼ 30 min-1, FiO2 $$\sim$$ ∼ 38%, CRP $$\sim$$ ∼ 152.3 mg/dL). Hypothesis testing provided solid statistical evidence supporting an interaction between phenotype and each clinical outcome: severity and mortality. By computing their corresponding odds ratios, a clear trend was found for higher frequencies of unfavourable evolution in phenotype C with respect to B, as well as more unfavourable in phenotype B than in A. Conclusion A compound unsupervised clustering technique (including a fully-automated optimization of its internal parameters) revealed the existence of three distinct groups of patients – phenotypes. In turn, these showed strong associations with the clinical severity in the progression of pneumonia, and with mortality.

El objetivo de este estudio fue conocer cómo se programa la competencia “Aprender a aprender” (AaA) en el currículum universitario y en qué medida se prevé que los estudiantes aprendan a aprender en la universidad. Se analizaron los componentes de AaA en los programas docentes de las universidades españolas, específicamente en las titulaciones de Pedagogía e Ingeniería en Telecomunicaciones. Se revisaron 20 321 competencias programadas para desarrollar a lo largo de 228 000 horas de formación. Se utilizó un modelo teórico para detectar la presencia de los componentes y se analizó su relación con las competencias disciplinares y transversales. Los resultados muestran la intención de enseñar a aprender para la disciplina, no sólo en sentido transversal; además, se observó un mayor peso al procesamiento de la información que al aprendizaje colaborativo y a la motivación. Se discuten las implicaciones teóricas de esta competencia y su transferencia entre disciplinas en educación superior.

This article introduces the possibility of studying graffiti using a colorimeter developed with Arduino hardware technology according to the Do It Yourself (DIY) philosophy. Through the obtained Red Green Blue (RGB) data it is intended to study and compare the information extracted from each of the graffiti present on different walls. The same color can be found in different parts of a single graffiti, but also in other graffiti that could a priori be of different authorship. Nevertheless, graffiti may be related, and it may be possible to group graffiti artists and "gangs" that work together. The methodology followed for the construction of the colorimeter and its real application in a practical case are described in four case studies. The case studies describe how graffiti were identified and recognized and they provide a comparison of the collected color samples. The results show the added value of the colorimeter in the graffiti recognition process, demonstrating its usefulness on a functional level. Finally, the contributions of this research are outlined, and an analysis is carried out of the changes to be made to the proposed method in the future, for improved graffiti color identification.

Objectives: Insulin resistance determined by Homeostasis Model of Insulin Resistance (HOMA-IR) has been associated with functional decline in non-diabetic older subjects. However, insulin is not routinely assessed. The study evaluated the predictive value of non-insulin-dependent IR surrogates on functional decline in non-diabetic older men and women. Design and participants: Prospective cohort study over 5 years. The study included 615 older participants from the Toledo Study of Healthy Aging. Methods: Frailty was assessed by the Frailty Trait Scale-5 (FTS-5) at baseline and after 5 years follow-up. 193 subjects experienced functional decline (2.5-point reduction in the FTS-5 score). Multivariate regression models analysed the effect of five described IR surrogates on functional decline considering potential confounders. Results: Among evaluated IR proxies, triglyceride glucose-body mass index (TyG-BMI) and HOMA-IR were significantly associated with an increased risk of functional decline (odd ratio (95% confidence interval) TyG-BMI: 1.16 (1.05, 1.28), p = 0.0035 and HOMA-IR: 1.59 (1.15, 2.21), p = 0.0056) among all participants. When stratified by gender, HOMA-IR was related to functional decline in men [2.02 (1.13, 3.59), p = 0.0173] and TyG-BMI in women [1.19 (1.05, 1.35), p = 0.0057]. Conclusions: Only TyG-BMI index mimics the predictive capacity of insulin-based IR marker. The predictive ability of IR indexes is gender-specific, being TyG-BMI the only index able to predict functional decline in women and HOMA-IR in men.

Introduction: The study aimed prevalence of primary and secondary headaches in children attending the Pain Clinic of Hospital General de México “Dr. Eduardo Liceaga”. Objective: The objective of the study was to identify the prevalence of headaches in children at the Pain Clinic of the Hospital General de México. Materials and methods: This was a descriptive, retrospective, cross-sectional, and observational study of pediatric patients between 5 and 17 years old at the Pediatric Algology service with a headache from January 1, 2012, to January 1, 2017. They were included and classified according to the type of headache, age, and gender. Results: During the time of the study, 4281 consultations were obtained with 526 patients with headaches. Twenty-three percent had primary headaches, most frequently migraine-type (18.25%) and secondary (12.54%) with vascular headache as the most frequent. Not included in any of these categories were the remaining 63.88% as under study. After 13 years of age, the most affected gender was female. Conclusions: Headaches are one of the most common complaints, the most frequent is primary. Its prevalence varies greatly and increases throughout childhood.