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Context: In the Peruvian context, generic drugs are those pharmaceutical products whose names correspond to the active ingredient of the drug and are not identified by a brand name; brand name drugs, on the other hand, are pharmaceutical products whose names are determined by the drug manufacturer. Aims: To know the perception of generic drugs by a Peruvian population. Methods: The type of research was applied, deductive method, non-experimental design, quantitative approach and cross-sectional. The sample consisted of 218 inhabitants, who were submitted to a questionnaire where the study variable was measured. Results: The main results showed that the level of information on generic drugs among the study sample was low (74,3%), as was consumption (66,5%), the level of confidence in these drugs was low (64,7%) and, finally, the inhabitants indicated that they had little access to generic drugs in their area (68,8%). Conclusions: The general perception of the study population towards generic drugs was low.

The access to molecular collections worldwide greatly improves the quality of scientific research by making a growing number of data available for investigation. The efforts on digitisation also aim at facilitating the exchange of material between institutions and researchers that must follow regulations in place and respect best practice. The handbook presented here proposes a workflow to follow to safely exchange materials, in accordance with international laws and legislation. We make numerous recommendations here to help the institutions and researchers to navigate the legal and administrative procedures, in order to manage molecular collections in the best way possible.

Problematic Internet use has become a major problem worldwide due to its numerous negative correlates in the field of health, both mental and physical, and its increasing prevalence, making it necessary to study both its risk and protective factors. Several studies have found a negative relationship between resilience and problematic Internet use, although the results are inconsistent. This meta-analysis assesses the relationship between problematic Internet use and resilience, and analyses its possible moderating variables. A systematic search was conducted in PsycInfo, Web of Science and Scopus. A total of 93,859 subjects from 19 studies were included in the analyses. The results show that there is a statistically-significant negative relationship (r = −0.27 (95% CI [−0.32, −0.22])), without evidence of publication bias. This meta-analysis presents strong evidence of the relationship between the two variables. Limitations and practical implications are discussed.

Abstract The service-learning disciplines can offer a unique opportunity for civic development in university students, as there is a large body of research that links it to values and civic attitudes including a vast number of ecological issues and citizen variables. Moreover, one should bear in mind that these students are future generations that will face many pressing social and environmental issues. Given the need to develop instruments to measure the impact of a service-learning methodology in university students’ values as well as civic attitudes, VAL-U is proposed. As the university can be considered a learning step prior to the professional field, the main objective of this study was to analyse the internal consistency and factor structure of the proposed VAL-U scale in the Spanish population. The scale confirmed acceptable psychometric properties. Furthermore, the results have shown high reliability and optimal goodness of fit. Promising results are offered to employ VAL-U as a valuable tool for assessing Values and Civic Attitudes Scale for Spanish-speaking University Students’ Service-Learning.

Background: Fetal posterior fossa fluid collections (PFFC) can range from normal variants to severe anomalies with highly variable neurological prognosis. The diagnosis of these entities is still a challenge for ultrasound as well as for fetal magnetic resonance imaging (MRI). The measurements of the brainstem-vermis angle (BV angle) and the brainstem-tentorium angle (BT angle) have been described as helpful in the differential diagnosis of the PFFC. Case: We present a case with posterior fossa abnormalities where the measurement of the BT angle could be difficult due to the anatomy distortion. Conclusion: We propose two alternative ways of measuring the BT angle that could be reliable in all the spectrum of PFFC.

AimTo assess the reproducibility of brainstem-vermis (BV) and brainstem-tentorium (BT) angles measured by fetal Magnetic Resonance Imaging (MRI) during second half of pregnancy in normal and abnormal fetuses. Secondly, to assess reproducibility of two alternative methodologies to measure the brainstem-tentorium angle (BT1 and BT2) proposed by our group that could be more reliable in fetuses with posterior fossa fluid collection (PFFC) anomalies. Finally, to describe the evolution of BV and BT angles along gestation in normal fetuses.MethodsWe conducted a cross-sectional study of BV and BT angles obtained by MRI performed at our center, in 22 fetuses with PFFC and 8 fetuses without PFFC to calculate both angles’ reproducibility and the correlation between them and the gestational age.ResultsWe found good interobserver reproducibility for the BV, BT1 and BT2 angles (Intraclass correlation coefficient: 0.98; 0.89 and 0.88 for each of these angles, with p < 0.001). In patients with PFFC the BT angle could not always be measured. BT angle presented a positive relationship with gestational age (p = 0.002) but BV angle stayed stable. The measurements of BV, BT1, and BT2 angles can be reliably performed by MRI with good interobserver reproducibility.ConclusionBV angle stays stable during pregnancy, whereas BT angle tends to augment with gestational age.

Abstract Background Community-acquired pneumonia (CAP) remains a leading cause of death worldwide, and hypoalbuminemia is associated with worse outcomes. However, it remains uncertain whether albumin administration could have any beneficial effects. We aim to assess whether the administration of albumin in hypoalbuminemic patients with CAP increases the proportion of clinically stable patients at day 5 compared with the standard of care alone. Methods This is a trial protocol for a superiority, non-blinded, multicenter, randomized, phase 3, interventional controlled clinical trial. The primary endpoint will be the proportion of clinical stable patients at day 5 (intention to treat), defined as those with stable vital signs for at least 24 h. The secondary endpoints will be time to clinical stability, duration of intravenous and total antibiotic treatment, length of hospital stay, intensive care unit admission, duration of mechanical ventilation and vasopressor treatment, adverse events, readmission within 30 days, and all-cause mortality. The trial has been approved by the Spanish Medicines and Healthcare Products Regulatory Agency. The investigators commit to publish the data in peer-reviewed journals within a year of the study completion date. Subjects will be recruited from three Spanish hospitals over a planned enrolment period of 2 years. A follow-up visit will be performed 1 month after discharge. We have estimated the need for a sample size of 360 patients at a two-sided 5% alpha-level with a power of 80% based on intention to treat. Eligible participants must be hospitalized, hypoalbuminemic (≤ 30 g/L), non-immunosuppressed, adults, and diagnosed with CAP. They will be randomly assigned (1:1) to receive standard care plus albumin (20 g in 100 mL) every 12 h for 4 days or standard care alone. Discussion If this randomized trial confirms the hypothesis, it should lead to a change in current clinical practice for the management of hypoalbuminemic patients with CAP. Trial registration European Clinical Trials Database (EudraCT) 2018-003117-18 . Registered on 12 April 2019. ClinicalTrials.gov NCT04071041 . Registered on 27 August 2019

Service-learning projects are an opportunity to work on both the empathy and the prosociality of university students. Transferring theoretical content to the real context in a practical way contributes to the acquisition of transversal skills of the subjects. The aim of this paper is to present experiences made with this methodology by a group of students of the subject of social psychology. They carried out several projects with different entities, although all of them were focused on responding to the needs of children and adolescents at risk of social exclusion, coming from problematic neighbourhoods and unstructured families, with hardly any resources to establish healthy interpersonal relationships. In these contexts, the university students detected problems of coexistence, lack of social cohesion, low emotional intelligence, presence of disruptive behaviors, scarce psycho-affective development and frustration with academic issues that affected both attention and behavior. The students’ intervention project to address this problem was carried out through networking with other NGOs and associations. It also focused basically on reinforcing the good practices that were already being carried out in the schools through school reinforcement, and they were taught to work as a team through games and sports activities. The results of this service contributed to improving children and adolescents’ social identity by working on their self-concept and self-esteem, promoting autonomy and strengthening skills to help them integrate into society without neglecting education in values such as solidarity, respect and responsibility. In addition, they learned tools such as negotiation and dialogue to solve their conflicts in the different areas of their lives. And the students valued the methodology positively, thus developing prosociality and empathy, the result of the learning experience derived from it both on a personal and academic level.

Introduction: Many severe COVID-19 patients require respiratory support and monitoring. An intermediate respiratory care unit (IMCU) may be a valuable element for optimizing patient care and limited health-care resources management. We aim to assess the clinical outcomes of severe COVID-19 patients admitted to an IMCU.Methods: Observational, retrospective study including patients admitted to the IMCU due to COVID-19 pneumonia during the months of March and April 2020. Patients were stratified based on their requirement of transfer to the intensive care unit (ICU) and on survival status at the end of follow-up. A multivariable Cox proportional hazards method was used to assess risk factors associated with mortality.Results: A total of 253 patients were included. Of them, 68% were male and median age was 65 years (IQR 18 years). Ninety-two patients (36.4%) required ICU transfer. Patients transferred to the ICU had a higher mortality rate (44.6 vs. 24.2%; p < 0.001). Multivariable proportional hazards model showed that age ≥65 years (HR 4.14; 95%CI 2.31–7.42; p < 0.001); chronic respiratory conditions (HR 2.34; 95%CI 1.38–3.99; p = 0.002) and chronic kidney disease (HR 2.96; 95%CI 1.61–5.43; p < 0.001) were independently associated with mortality. High-dose systemic corticosteroids followed by progressive dose tapering showed a lower risk of death (HR 0.15; 95%CI 0.06–0.40; p < 0.001).Conclusions: IMCU may be a useful tool for the multidisciplinary management of severe COVID-19 patients requiring respiratory support and non-invasive monitoring, therefore reducing ICU burden. Older age and chronic respiratory or renal conditions are associated with worse clinical outcomes, while treatment with systemic corticosteroids may have a protective effect on mortality.

There are several assessment rubrics for service- learning projects that are presented in the academic field. Each one puts the emphasis on some specific aspects responding to its purpose. Attending to the concern for having an evaluation tool in this area that would respond to the integral education of the students and valuing the interesting contributions of Pope Francisco in the matter of education, an exhaustive tracking of his writings has been carried out. From an analysis of them, the educational keys of their pedagogy have been proposed that will serve as the basis for the elaboration of an evaluative rubric of the Learning- Service projects. A fundamental line is based on understanding these projects as an opportunity to humanize education, thus highlighting anthropological and existential factors such as the development of interiority and the spiritual-personal dimension. The educator is, therefore, a guide that helps the personal growth and maturation of the students. The objective of this paper is to examine a Rubric for the assessment of Service Learning Experiences in order to promote training and the integral development of the student. This is structured into two intersecting axes: person and context. It comprises six dimensions: culture, education, social agents, learning, values and service. Each dimension evaluates 5 pedagogical categories that are evaluated in 4 levels. Tools of this type allow students to be motivated in prosocial behavior. Thus, they are agents of social transformation and develop an active citizenship that works for a more just and peaceful society.

BackgroundA higher incidence of thrombotic events, mainly pulmonary embolism (PE), has been reported in hospitalized patients with COVID-19. The main objective was to assess clinical and laboratory differences in hospitalized COVID-19 patients according to occurrence of PE.MethodsThis retrospective study included all consecutive patients hospitalized with COVID-19 who underwent a computed tomography (CT) angiography for PE clinical suspicion. Clinical data and median blood test results distributed into weekly periods from COVID-19 symptoms onset, were compared between PE and non-PE patients.ResultsNinety-two patients were included, 29 (32%) had PE. PE patients were younger (63.9 (SD 13.7) vs 69.9 (SD 12.5) years). Clinical symptoms and COVID-19 CT features were similar in both groups. PE was diagnosed after a mean of 20.0 (SD 8.6) days from the onset of COVID-19 symptoms. Corticosteroid boluses were more frequently used in PE patients (62% vs. 43%). No patients met ISTH DIC criteria. Any parameter was statistically significant or clinically relevant except for D-Dimer when comparing both groups. Median values [IQR] of D-dimer in PE vs non-PE patients were: week 2 (2010.7 [770.1-11208.9] vs 626.0 [374.0-2382.2]; p = 0.004); week 3 (3893.1 [1388.2-6694.0] vs 1184.4 [461.8-2447.8]; p = 0.003); and week 4 (2736.3 [1202.1-8514.1] vs 1129.1 [542.5-2834.6]; p = 0.01). Median fold-increase of D-dimer between week 1 and 2 differed between groups (6.64 [3.02-23.05] vs 1.57 [0.64-2.71], p = 0.003); ROC curve AUC was 0.879 (p = 0.003) with a sensitivity and specificity for PE of 86% and 80%, respectively.ConclusionsAmong hospitalized COVID-19 patients, D-dimer levels are higher at weeks 2, 3 and 4 after COVID-19 symptom onset in patients who develop PE. This difference is more pronounced when the fold increase between weeks 1 and 2 is compared.

Abstract Background The enzymatic replacement therapy (ERT) availability for Gaucher disease (GD) has changed the landscape of the disease, several countries have screening programs. These actions have promoted the early diagnosis and avoided many complications in pediatric patients. In Spain ERT has been available since 1993 and 386 patients have been included in the Spanish Registry of Gaucher Disease (SpRGD). The aim of this study is to analyze the impact of ERT on the characteristics at time of diagnosis and initial complications in pediatric Gaucher disease patients. Aim To analyze the impact of ERT on the characteristics at time of diagnosis and initial complications in pediatric Gaucher disease patients. Methods A review of data in SpRGD from patients’ diagnosed before 18 years old was performed. The cohort was split according the year of diagnosis (≤1994, cohort A; ≥1995, cohort B). Results A total of 98 pediatric patients were included, GD1: 80, GD3: 18; mean age: 7.2 (0.17–16.5) years, 58 (59.2%) males and 40 (40.8%) females. Forty-five were diagnosed ≤ 1994 and 53 ≥ 1995. Genotype: N370S/N370S: 2 (2.0%), N370S/L444P: 27 (27.5%), N370S/other: 47 (48%), L444P/L444P: 7 (7.1%), L444P/D409H: 2 (2.0%), L444P/other: 3 (6.2%), other/other: 10 (10.2%). The mean age at diagnosis was earlier in patients diagnosed after 1995 (p

Polycyclic aromatic hydrocarbons (PAHs) and trace metals are pollutants widely distributed in the marine environment with toxic effects on live organisms, but few laboratory studies have proved their causal relationship with histopathologic alterations from invertebrates. We analyse the histopathologic effects of a tar mixture used in mussel farms on the gonad of male mussels. Mussels were exposed to water-accommodated fractions from different sub-lethal concentrations of that tar mixture during different times. The accumulation of PAHs and metals in mussels was quantified in each one tar exposure condition, and a comparative histological and morphometric analysis of the male gonad was performed, as well as of the gametogenic disorders and the cellular pathologies induced. Spermatogenesis disruption and alterations of somatic and germinal cells were observed as a direct effect of treatment. The pathologies observed followed an increasing malignity sequence depending on dose and exposure time: spawning induction; arrest of spermatogenesis and spermiogenesis; suppression of immune response; dysplasia of Sertoli and connective cells and finally, severe disorders of germinal cells. We demonstrate for the first time that tar used in waterproofing of floating rafts from the mussel farms causes severe effects on male mussel gonad, constituting a direct risk to the health of these organisms, affecting gametogenesis, quality of gametes and, ultimately, the sustainability of this resource and their quality for human consumption. Moreover, we propose the pathologies described in mussel as biomarkers of marine pollution and the mussel gonad as study model of testicular toxicity mechanisms in male reproduction.

The secondary cysts of the fish pathogen oomycete Saprolegnia parasitica possess bundles of long hooked hairs that are characteristic to this economically important pathogenic species. Few studies have been carried out on elucidating their specific role in the S. parasitica life cycle and the role they may have in the infection process. We show here their function by employing several strategies that focus on descriptive, developmental and predictive approaches. The strength of attachment of the secondary cysts of this pathogen was compared to other closely related species where bundles of long hooked hairs are absent. We found that the attachment of the S. parasitica cysts was around three times stronger than that of other species. The time sequence and influence of selected factors on morphology and the number of the bundles of long hooked hairs conducted by scanning electron microscopy study revealed that these are dynamic structures. They are deployed early after encystment, i.e., within 30 sec of zoospore encystment, and the length, but not the number, of the bundles steadily increased over the encystment period. We also observed that the number and length of the bundles was influenced by the type of substrate and encystment treatment applied, suggesting that these structures can adapt to different substrates (glass or fish scales) and can be modulated by different signals (i.e., protein media, 50 mM CaCl2 concentrations, carbon particles). Immunolocalization studies evidenced the presence of an adhesive extracellular matrix. The bioinformatic analyses of the S. parasitica secreted proteins showed that there is a high expression of genes encoding domains of putative proteins related to the attachment process and cell adhesion (fibronectin and thrombospondin) coinciding with the deployment stage of the bundles of long hooked hairs formation. This suggests that the bundles are structures that might contribute to the adhesion of the cysts to the host because they are composed of these adhesive proteins and/or by increasing the surface of attachment of this extracellular matrix.

The aim of this research is to study the behaviour of expletive pronouns in the acquisition of English as a second language. We will analyze the processes involved in the acquisition of a first and a second language in order to investigate if expletive pronouns play such an important role in the acquisition of English as a second language as they do in first languages.

Fruits are one of the most important sources of polyphenols for humans, whether they are consumed fresh or as processed products. To improve the phenolic content of fruits, a novel field of interest is based on results obtained using elicitors, agrochemicals which were primarily designed to improve resistance to plant pathogens. Although elicitors do not kill pathogens, they trigger plant defense mechanisms, one of which is to increase the levels of phenolic compounds. Therefore, their application not only allows us to control plant disease but also to increase the phenolic content of plant foodstuffs. Pre- or post-harvest application of the most commonly used elicitors to several fruits is discussed in this review.

Content and Language Integrated Learning (CLIL) seems to be fully accepted as the preferred approach at present to promote multilingualism in Europe. Spain has also followed this trend, although the way it has been implemented varies depending on the community involved, whether monolingual or bilingual, since in the latter case the foreign language, usually English, adds to two previous languages. The aim of this paper is to carry out a comparison of the linguistic competence attained in two bilingual communities, namely the Basque Country and Catalonia, two settings where we find both educational approaches: on the one hand, a traditional English as a Foreign Language (non-CLIL) strand and, on the other, the CLIL strand. More precisely, we will analyse the written competence that secondary students reach in these two communities when different variables are considered. Firstly, we will compare the educational approach followed in the communities (CLIL versus non-CLIL) and, secondly, we will analyse the influence of the number of hours of instruction in two different age groups. Our results demonstrate that the amount of instruction has an important bearing on written competence, irrespective of the approach followed in the classroom.

Several miRNAs are conserved in different plant families, but their abundance and target genes vary between species, organs, and stages of development. Target genes of miRNAs are mostly transcription factors, involved in the control of many plant developmental processes, including fruit development. MiR164 is a conserved miRNA, highly expressed in fruits, and is validated to target a subset of genes of the NAC-domain transcription factor gene family. The objective of this work was to analyze the phenotypic effects of the constitutive expression of miR164 during the life cycle of Arabidopsis and tomato. MiR164 overexpression (164-OE) lines for Arabidopsis and tomato were generated and analyzed during plant development. The constitutive miR164 expression showed that miR164 affected the morphology of Arabidopsis and tomato, and it affected the transition from the vegetative to the reproductive phase in Arabidopsis. Moreover, the miR164 overexpression affected the time required for each developmental stage of tomato fruit. These results suggest that miR164 plays general and specific roles during development in Arabidopsis and tomato, including fruit development, which could be exploited for the improvement of traits of agronomic interest in important species.

This paper explores the characteristics of the anthocyanin and flavonol composition and content in grapes from plants resulting from intraspecific crosses of Vitis vinifera varieties Monastrell × Cabernet Sauvignon, Monastrell × Syrah, and Monastrell × Barbera, in order to acquire information for future breeding programs. The anthocyanin and flavonol compositions of twenty-seven hybrids bearing red grapes and 15 hybrids bearing white grapes from Monastrell × Syrah, 32 red and 6 white from Monastrell × Cabernet Sauvignon, and 13 red from Monastrell × Barbera have been studied. Among the intraspecific crosses, plants with grapes presenting very high concentrations of anthocyanins and flavonols were found, indicating a transgressive segregation for this character, and this could lead to highly colored wines with an increased benefits for human health. As regards the qualitative composition of anthocyanins and flavonols, the hydroxylation pattern of the hybrids that also may influence wine color hue and stability presented intermediate values to those of the parentals, indicating that values higher than that showed by the best parental in this respect will be difficult to obtain. The results presented here can be helpful to acquire information for future breeding efforts, aimed at improving fruit quality through the effects of flavonoids.

El presente articulo investiga la actuación de distintos pronombres sujeto en la adquisición de un sistema no nativo. Por un lado, estudiamos la evolución en el proceso adquisitivo de los sujetos referenciales. Por otro, analizamos algunas construcciones con sujetos pleonásticos, que incluyen oraciones existenciales y construcciones de concordancia copulativa. Tras realizar varias pruebas a estudiantes españoles de inglés, pudimos determinar cómo el proceso adquisitivo dijiere con respec­ to a los distintos sujetos. Los pronombres pleonásticos fueron los últimos en adquirirse, sobre todo en aquellos contextos que resultan semánticamente complejos para los hablantes nativos de español, como es el caso de las construcciones de concordancia copulativa. Estos resultados harán que debamos replantearnos algunas teorias sobre el valor de los sujetos pleonasticos en la reestructuración del parametro de Sujeto Nulo.

Content and Language Integrated Learning (CLIL) is a multifaceted educational approach which has emerged as a major innovation in improving language learning and subject learning in the curriculum. In order to analyse the effect of this approach, a number of studies (Dalton Puffer, C., T. Nikula and U. Smit, eds. 2010. "Language Use and Language Learning in CLIL Settings." Amsterdam: John Benjamins; Ruiz de Zarobe, Y. and R.M. Jiménez Catalán, ed. 2009. "Content and Language Integrated Learning: Evidence from Research in Europe." Bristol: "Multilingual Matters"; Ruiz de Zarobe, Sierra, and Gallardo del Puerto. ed. 2011. "Content and Foreign Language Integrated Learning: Contributions to Multilingualism in European Contexts." Bern: Peter Lang) have provided a comprehensive compilation of some of the learning outcomes of CLIL settings. The majority of these studies have supported the benefits of the integrative approach in formal contexts; however, there is very little research about the fundamental concept of learning strategies and strategic instruction in CLIL, even though learning strategies are an integral part of the curricular elements that help students to learn. In this paper, we examine whether strategic instruction, centred on reading strategies, can provide the specific techniques that are needed for successful language learning in CLIL settings (Chamot, A.U. 2001. Teaching learning strategies in immersion classrooms [Bridge insert]. "The Elementary Immersion Learning Strategies Resource Guide" (2nd ed.). http://www.nclrc.org/eils). For our research, we have developed a strategic training programme in reading for students in primary education taught through a Trilingual Education Framework (Basque-Spanish-English) in the Basque Country, Spain. One of our groups received strategic training in reading skills for a period of seven weeks, while the other group did not. Pre-tests and post-tests were carried out for both the control group (no strategic instruction) and the experimental group (strategic instruction). Results indicate that those students who were trained strategically in reading seemed to have greater metacognitive awareness and thus, they obtained better results. However, no significant differences were found between the number and types of strategies used in both groups. Some explanation related to the influence of age and the length of the training procedure will be discussed.

This article focuses on the description of one of the main features of current multilingualism, complexity, through a selection of issues related to its role in L2 acquisition, as the proper notion of multilingualism, multilingualism as a social phenomenon and multilingualism as a multidimensional phenomenon. We also present several aspects of multilingualism in its relationship to L2 acquisition, notably some involved in the notion of multilingualism as a holistic process, and the contexts of multilingual language acquisition, and illustrate new findings of multilingualism in these areas, both from a theoretical and research perspective.

Since Do Coyle and Hugo Baetens Beardsmore published their Special Issue on "Research on Content and Language Integrated Learning (CLIL)" in the "International Journal of Bilingual Education and Bilingualism" in 2007, there has been a great deal of interest and debate about the approach, which under the umbrella term of Content and Language Integrated Learning refers to contexts where language is used as a medium for learning content, and the content is also used as a resource for learning languages. As has quite often been pointed out in the literature (Dalton-Puffer 2011; Huttner, Dalton-Puffer, and Smit, this issue; Shohamy 2006), the implementation of CLIL has been supported, on the one hand, by language policy-makers, stakeholders and European institutions and, on the other, by individual initiatives undertaken by school communities, teachers and parents, all of them seeking to improve foreign-language competence in a world where globalization and the knowledge society are encouraging foreign-language learning and communication. Despite the hegemony of English as a global language, CLIL has been conceived to enhance language competence and communication in an ever-growing multilingual society where, in the case of the EU, 23 official languages coexist with more than 60 regional or minority languages, some of which have official status (Basque, Catalan and Sami, among others). Additionally, there are hundreds of other languages which immigrant communities provide. This multilingual diversity calls for an educational approach that can become an appropriate vehicle for intercultural communication. Consequently, CLIL can be understood as a truly European approach for the integration of language and content in the curriculum as part of the international mosaic of multilingualism. This paper will provide an overview of some of the models that sustain CLIL as a flexible and rich teaching approach in order to gain some insight into this area.