COVID-19 in transplant recipients: The Spanish experience.

We report the nationwide experience with solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients diagnosed with coronavirus disease 2019 (COVID-19) in Spain until 13 July 2020. We compiled information for 778 (423 kidney, 113 HSCT, 110 liver, 69 heart, 54 lung, 8 pancreas, 1 multivisceral) recipients. Median age at diagnosis was 61 years (interquartile range [IQR]: 52-70), and 66% were male. The incidence of COVID-19 in SOT recipients was two-fold higher compared to the Spanish general population. The median interval from transplantation was 59 months (IQR: 18-131). Infection was hospital-acquired in 13% of cases. No donor-derived COVID-19 was suspected. Most patients (89%) were admitted to the hospital. Therapies included hydroxychloroquine (84%), azithromycin (53%), protease inhibitors (37%), and interferon-ß (5%), whereas immunomodulation was based on corticosteroids (41%) and tocilizumab (21%). Adjustment of immunosuppression was performed in 85% of patients. At the time of analysis, complete follow-up was available from 652 patients. Acute respiratory distress syndrome occurred in 35% of patients. Ultimately, 174 (27%) patients died. In univariate analysis, risk factors for death were lung transplantation (odds ratio [OR]: 2.5; 95% CI: 1.4-4.6), age >60 years (OR: 3.7; 95% CI: 2.5-5.5), and hospital-acquired COVID-19 (OR: 3.0; 95% CI: 1.9-4.9).

Exploiting xylan as sugar donor for the synthesis of an antiproliferative xyloside using an enzyme cascade.

BACKGROUND: Currently, industrial societies are seeking for green alternatives to conventional chemical synthesis. This demand has merged with the efforts to convert lignocellulosic biomass into value-added products. In this context, xylan, as one of main components of lignocellulose, has emerged as a raw material with high potential for advancing towards a sustainable economy. RESULTS: In this study, the recombinant endoxylanase rXynM from the ascomycete Talaromyces amestolkiae has been heterologously expressed in Pichia pastoris and used as one of the catalysts of an enzyme cascade developed to synthesize the antiproliferative 2-(6-hydroxynaphthyl) ß-D-xylopyranoside, by transglycosylation of 2,6-dihydroxynaphthalene. The approach combines the use of two fungal xylanolytic enzymes, rXynM and the ß-xylosidase rBxTW1 from the same fungus, with the cost-effective substrate xylan. The reaction conditions for the cascade were optimized by a Central Composite Design. Maximal productions of 0.59 and 0.38 g/L were reached using beechwood xylan and birchwood xylan, respectively. For comparison, xylans from other sources were tested in the same reaction, suggesting that a specific optimization is required for each xylan variety. The results obtained using this enzyme cascade and xylan were similar or better to those previously reported for a single catalyst and xylobiose, an expensive sugar donor. CONCLUSIONS: Beechwood and birchwood xylan, two polysaccharides easily available from biomass, were used in a novel enzyme cascade to synthetize an antiproliferative agent. The approach represents a green alternative to the conventional chemical synthesis of 2-(6-hydroxynaphthyl) ß-D-xylopyranoside using a cost-effective substrate. The work highlights the role of xylan as a raw material for producing value-added products and the potential of fungal xylanolytic enzymes in the biomass conversion.

Bile-induced promoters for gene expression in Lactobacillus strains.

Bioengineering of probiotics allows the improvement of their beneficial characteristics. In this work, we develop a molecular tool that would allow the activation of desirable traits in probiotics once they reach the intestine. The activity of upstream regions of bile-inducible genes of Lactobacillus casei BL23 and Lactobacillus plantarum WCFS1 was analyzed using plasmids encoding an anaerobic fluorescent protein as reporter. The promoter P16090 from Lb. casei BL23 was selected and its bile induction confirmed in Lb. casei BL23, Lb. plantarum WCFS1, and in Lactobacillus rhamnosus and Lactobacillus reuteri strains. However, the induction did not occur in Lactococcus lactis MG1363 or Bifidobacterium strains. Studies with different bile compounds revealed the importance of cholic acid in the bile induction process. Induction of fluorescence was also confirmed for transformed Lb. casei BL23 under simulated colonic conditions and in the presence of intestinal microbiota. The developed vector, pNZ:16090-aFP, constitutes a promising tool suitable for the expression of genes of interest under intestinal conditions in probiotic strains of the species Lb. casei, Lb. plantarum, Lb. rhamnosus, and Lb. reuteri.

Development and Assessment of the SMAP Enhanced Passive Soil Moisture Product.

Launched in January 2015, the National Aeronautics and Space Administration (NASA) Soil Moisture Active Passive (SMAP) observatory was designed to provide frequent global mapping of high-resolution soil moisture and freeze-thaw state every two to three days using a radar and a radiometer operating at L-band frequencies. Despite a hardware mishap that rendered the radar inoperable shortly after launch, the radiometer continues to operate nominally, returning more than two years of science data that have helped to improve existing hydrological applications and foster new ones. Beginning in late 2016 the SMAP project launched a suite of new data products with the objective of recovering some high-resolution observation capability loss resulting from the radar malfunction. Among these new data products are the SMAP Enhanced Passive Soil Moisture Product that was released in December 2016, followed by the SMAP/Sentinel-1 Active-Passive Soil Moisture Product in April 2017. This article covers the development and assessment of the SMAP Level 2 Enhanced Passive Soil Moisture Product (L2_SM_P_E). The product distinguishes itself from the current SMAP Level 2 Passive Soil Moisture Product (L2_SM_P) in that the soil moisture retrieval is posted on a 9 km grid instead of a 36 km grid. This is made possible by first applying the Backus-Gilbert optimal interpolation technique to the antenna temperature (TA) data in the original SMAP Level 1B Brightness Temperature Product to take advantage of the overlapped radiometer footprints on orbit. The resulting interpolated TA data then go through various correction/calibration procedures to become the SMAP Level 1C Enhanced Brightness Temperature Product (LiC_TB_E). The LiC_TB_E product, posted on a 9 km grid, is then used as the primary input to the current operational SMAP baseline soil moisture retrieval algorithm to produce L2_SM_P_E as the final output. Images of the new product reveal enhanced visual features that are not apparent in the standard product. Based on in situ data from core validation sites and sparse networks representing different seasons and biomes all over the world, comparisons between L2_SM_P_E and in situ data were performed for the duration of April 1, 2015 - October 30, 2016. It was found that the performance of the enhanced 9 km L2_SM_P_E is equivalent to that of the standard 36 km L2_SM_P, attaining a retrieval uncertainty below 0.040 m3/m3 unbiased root-mean-square error (ubRMSE) and a correlation coefficient above 0.800. This assessment also affirmed that the Single Channel Algorithm using the V-polarized TB channel (SCA-V) delivered the best retrieval performance among the various algorithms implemented for L2_SM_P_E, a result similar to a previous assessment for L2_SM_P.

Relationship between hyperspectral indices, agronomic parameters and phenolic composition of Vitis vinifera cv Tempranillo grapes.

BACKGROUND: The phenolic composition of grapes is key when making decisions about harvest date and ensuring the quality of grapes. The present study aimed to investigate the relationship between the detailed phenolic composition of grapes and the agronomic parameters and hyperspectral indices, with the latter being measured via field radiometry techniques. RESULTS: Good correlations were found between phenolic composition (both anthocyanin and flavanol composition) and some hyperspectral indices related to vigor, such as the NDVI (normalized difference vegetation index) and the SAVI (soil adjusted vegetation index). The strongest correlations were observed between the phenolic composition of grape skin at harvest time and variables measured from grapes at veraison time, as well as variables determined from grapevines at harvest time. The potential usefulness of these hyperspectral indices calculated from measurements performed directly on grapes or grapevines for estimating the anthocyanin and flavanol composition of grape skins was indicated by the high coefficients of determination (R2 = 0.7955 and R2 = 0.8594, respectively) as obtained by means of principal component regression. CONCLUSION: According to the results of the present study, hyperspectral indices calculated from measurements performed directly on grapes at veraison time or on grapevines at harvest time may be useful for estimating the anthocyanin and flavanol composition of grape skins. This suggests that field radiometry might provide valuable information for estimating the phenolic composition of grapes, which may prove to be very useful when establishing strategies for harvest planning. © 2017 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Influence of atmospheric patterns on soil moisture dynamics in Europe.

Soil moisture (SM) plays a key role in the water cycle, and its variability is intimately linked to coupled land-atmosphere processes. Having a good knowledge of soil-atmospheric interactions is thus essential to assess the impact of climate change on SM; however, many aspects of how water and energy exchanges occur in the soil-atmosphere continuum are still uncertain. In particular, it is known that atmospheric circulation patterns influence climate conditions over Europe but their impact on SM has only rarely been studied. This study provides insight into how atmospheric patterns influence soil moisture dynamics in Europe, where an increase in temperature and agricultural droughts are expected as an impact of climate change. To do so, we analysed the influence of the North Atlantic Oscillation (NAO), the Arctic Oscillation (AO), and the El Niño Southern Oscillation (ENSO) on European SM, including lagged responses, for the period 1991-2020 at a monthly scale. Two methods have been used: a lagged correlation analysis and a more sophisticated causality approach using the PCMCI (PC method combined with the momentary conditional independence (MCI) test). SM series from two different databases were considered: the hydrological model LISFLOOD and the reanalysis dataset ERA5-Land. The results from the correlation analysis showed a significant, predominantly negative relationships of SM with NAO and AO over almost all of Europe and no significant relation with ENSO. With the causality analysis, similar patterns are obtained for NAO and AO; however, the PCMCI analysis revealed clear patterns of ENSO influencing SM with a delayed response of one-to-two months in central and northwest Europe. The results obtained in this work highlight that there are causal relations between the main modes of interannual climate oscillations and SM variations in Europe, underlining the importance of accounting for global atmospheric circulations to study current changes in regional soil water-related processes.

A Systematic Review on Spinal Asymmetries in Case Studies of Unilateral Nephroptosis from a Viscerosomatic Point of View.

The assessment of posture and asymmetries is common in musculoskeletal clinical practice, and correction is a frequent goal. In this setting, posture and asymmetries are usually interpreted in terms of musculoskeletal issues. This study aimed to evaluate spinal asymmetries in case studies of unilateral nephroptosis. A systematic review was performed using PubMed, CINAHL, Scopus and Web of Science. We included case reports and case series of nephroptotic patients which showed diagnostic imaging that allowed us to assess the presence of spinal asymmetries in the frontal plane. The methodological quality of the selected studies was assessed by using Case Report (CARE) checklist. Nineteen studies were included, with a total number of 78 reported patients (69 women) ranging 22 to 44 years old (mean: 29). Only one patient presented with medial nephroptosis, while the rest presented with caudal migration. Ninety-one percent of the cases affected to the right kidney. All cases but two showed homolateral flank closure (lower rib descent, iliac crest raise and/or homolateral side-bending). The correction of nephroptosis, either by supine position or surgical treatment, removed asymmetries in some cases while other cases improved only partly. Manual therapists must consider visceral implications while assessing body posture. Further, since the most common symptom of nephroptosis is loin pain, and it has been claimed that loin pain is underdiagnosed, manual therapists should consider its potential presence during clinical practice. Finally, being that nephroptosis shares several features with idiopathic lumbar scoliosis (type of patient, postural adaptation), more research is needed regarding any possible relation between them.

Eya2 promotes cell cycle progression by regulating DNA damage response during vertebrate limb regeneration.

How salamanders accomplish progenitor cell proliferation while faithfully maintaining genomic integrity and regenerative potential remains elusive. Here we found an innate DNA damage response mechanism that is evident during blastema proliferation (early- to late-bud) and studied its role during tissue regeneration by ablating the function of one of its components, Eyes absent 2. In eya2 mutant axolotls, we found that DNA damage signaling through the H2AX histone variant was deregulated, especially within the proliferating progenitors during limb regeneration. Ultimately, cell cycle progression was impaired at the G1/S and G2/M transitions and regeneration rate was reduced. Similar data were acquired using acute pharmacological inhibition of the Eya2 phosphatase activity and the DNA damage checkpoint kinases Chk1 and Chk2 in wild-type axolotls. Together, our data indicate that highly-regenerative animals employ a robust DNA damage response pathway which involves regulation of H2AX phosphorylation via Eya2 to facilitate proper cell cycle progression upon injury.

Temporal Stability of Soil Moisture and Radar Backscatter Observed by the Advanced Synthetic Aperture Radar (ASAR).

The high spatio-temporal variability of soil moisture is the result of atmosphericforcing and redistribution processes related to terrain, soil, and vegetation characteristics.Despite this high variability, many field studies have shown that in the temporal domainsoil moisture measured at specific locations is correlated to the mean soil moisture contentover an area. Since the measurements taken by Synthetic Aperture Radar (SAR)instruments are very sensitive to soil moisture it is hypothesized that the temporally stablesoil moisture patterns are reflected in the radar backscatter measurements. To verify this hypothesis 73 Wide Swath (WS) images have been acquired by the ENVISAT AdvancedSynthetic Aperture Radar (ASAR) over the REMEDHUS soil moisture network located inthe Duero basin, Spain. It is found that a time-invariant linear relationship is well suited forrelating local scale (pixel) and regional scale (50 km) backscatter. The observed linearmodel coefficients can be estimated by considering the scattering properties of the terrainand vegetation and the soil moisture scaling properties. For both linear model coefficients,the relative error between observed and modelled values is less than 5 % and thecoefficient of determination (R²) is 86 %. The results are of relevance for interpreting anddownscaling coarse resolution soil moisture data retrieved from active (METOP ASCAT)and passive (SMOS, AMSR-E) instruments.

Identification of regenerative roadblocks via repeat deployment of limb regeneration in axolotls.

Axolotl salamanders are powerful models for understanding how regeneration of complex body parts can be achieved, whereas mammals are severely limited in this ability. Factors that promote normal axolotl regeneration can be examined in mammals to determine if they exhibit altered activity in this context. Furthermore, factors prohibiting axolotl regeneration can offer key insight into the mechanisms present in regeneration-incompetent species. We sought to determine if we could experimentally compromise the axolotl's ability to regenerate limbs and, if so, discover the molecular changes that might underlie their inability to regenerate. We found that repeated limb amputation severely compromised axolotls' ability to initiate limb regeneration. Using RNA-seq, we observed that a majority of differentially expressed transcripts were hyperactivated in limbs compromised by repeated amputation, suggesting that mis-regulation of these genes antagonizes regeneration. To confirm our findings, we additionally assayed the role of amphiregulin, an EGF-like ligand, which is aberrantly upregulated in compromised animals. During normal limb regeneration, amphiregulin is expressed by the early wound epidermis, and mis-expressing this factor lead to thickened wound epithelium, delayed initiation of regeneration, and severe regenerative defects. Collectively, our results suggest that repeatedly amputated limbs may undergo a persistent wound healing response, which interferes with their ability to initiate the regenerative program. These findings have important implications for human regenerative medicine.

Tratamiento osteopático en el asma / No disponible

Introducción: el asma es actualmente una de las enfermedades crónicas más comunes en el mundo que afecta a 300 millones de personas. Su diagnóstico se basa en la presencia de disnea, tos y sibilancias, la ausencia de una explicación alternativa para ello, y la realización de una espirometría que demuestre la obstrucción reversible de la vía aérea. Objetivos: el objetivo de este trabajo es proporcionar una revisión actualizada de las evidencias publicadas en la literatura sobre el tratamiento osteopático en el asma y las diferentes técnicas utilizadas en los estudios realizados. Material y métodos: se realizó una búsqueda en las bases de datos electrónicas MEDLINE, SciELO y ScienceDirect para la que se utilizaron los términos asma, manipulación espinal, quiropraxia, terapia manual, medicina alternativa, medicina osteopática, tratamiento manipulativo osteopático y enfermedad pulmonar. Se incluyeron las publicaciones que tenían al menos un tamaño muestral de 6 sujetos con una situación médica estable y que analizan la efectividad de la manipulación vertebral incluyendo resultados clínicos como la función pulmonar, uso de medicación y síntomas. Se excluyeron los artículos publicados de forma incompleta (abstract), los estudios clínicos no aleatorizados, las revisiones sistemáticas, estudios de casos y/o estudios piloto con una muestra inferior a 6 sujetos, aquellos que no incluían resultados clínicos y/o que no contaban con un grupo control. Resultados: de un total de 1056 publicaciones recuperadas para la presente revisión, 8 ensayos clínicos aleatorizados cumplían los criterios de inclusión y exclusión. Conclusiones: tras la realización de la revisión sistemática de los artículos seleccionados concluimos que actualmente no existen evidencias suficientes que sugieran que el tratamiento manual osteopático de la columna vertebral en sujetos asmáticos en combinación con el tratamiento médico óptimo es efectivo. Las investigaciones futuras deben mejorar los criterios metodológicos de calidad

No disponible

Variación de los volúmenes respiratorios en el sujeto asmático tras la técnica de impulso en rotación sentado de la charnela dorsolumbar / Variation in lung volume in asthmatic subjects after applying the thrust technique in rotation to the thoracolumbar junction

Introducción: El asma es una de las enfermedades crónicas más comunes en el mundo que afecta a 300 millones de personas. El objetivo del tratamiento es un buen control de la enfermedad que reduzca el número de exacerbaciones y mejore la calidad de vida del paciente, pero pese a su reconocida eficacia, los fármacos no llegan a controlar a todos los asmáticos y su uso presenta riesgos y efectos secundarios. Objetivos: Determinar las posibles variaciones de la capacidad vital forzada (FVC), el volumen espiratorio forzado en el primer segundo (FEV1), Coeficiente FEV1/FVC y cuestionario de calidad de vida MiniAQLQ tras la técnica de impulso en rotación sentado bilateral de la charnela dorso-lumbar en el sujeto asmático. Material y métodos: Se realizó un ensayo clínico, controlado, aleatorizado en 24 sujetos asmáticos (n=24). Analizamos las posibles variaciones en los valores espirométricos del FVC, el FEV1, la relación FEV1/FVC, y el cuestionario de calidad de vida MiniAQLQ. El análisis de estas variables respecto al momento pre-intervención se realizo en tres momentos: 1 minuto post-intervención, 30 minutos post-intervención y 1 semana post-intervención. Resultados: Los resultados obtenidos muestran que las diferencias entre el Grupo Experimental (GE) y el Grupo Control (GC) son estadísticamente significativas para el Coeficiente FEV1/FVC al minuto post-intervención (p=0,023), pero no existen cambios estadísticamente significativos para las demás variables en ninguno de los momentos post-intervención respecto a la medición pre-intervención. Si se observa que existen diferencias entre las medidas post-intervención tanto en la FVC como en el FEV1 son mayores en el GE frente al GC cuanto mayor es el tiempo transcurrido desde la intervención. Conclusiones: Existen variaciones estadísticamente significativas en la relación FEV1/FVC al minuto post-intervención. No se aprecian variaciones estadísticamente significativas para las demás variables en el resto de mediciones

Introduction: asthma is one of the most common chronic diseases in theworld; it affects 300 million people. The objective of treatment is to control the disease, reducing the number of exacerbations and improving the patient's quality of life. However, despite the known effectiveness of the medication, it does not control the disease in all patients and it can present risks and secondary effects. Objectives: to determine whether the thrust technique in rotation applied bilaterally to the thoracolumbar junction in asthmatic subjects while seated produces variations in forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio and MiniAQLQ quality of life. Materials and Methods: we carried out a controlled, randomised clinical trial on 24 asthmatic subjects (n=24). We analysed any variation in the following spirometric variables: FVC, FEV1, FEV1/FVC ratio and MiniAQLQ quality of life. These variables were measured against the pre-intervention values at three points in time: 1 minute post-intervention, 30 minutes post-intervention and 1 week post-intervention. Results: the results obtained show that the difference in FEV1/FVC ratio 1 minute post-intervention between the Experimental Group (EG) and the Control Group (CG) was statistically significant (p=0.023). However there were no statistically significant changes in any of the other variables from pre-intervention to 1 minute, 30 minutes or 1 week post-intervention. We did observe differences between the post-intervention results for both FVC and FEV1. They were higher in the EG than the CG and the difference increased as more time elapsed since the intervention. Conclusions: There were statistically significant variations in FEV1/FVC ratio 1 minute post-intervention. There were no statistically significant variations in any of the other variables at any point in time post-intervention

Tratamiento osteopático del asma intrínseco. Serie de casos / No disponible

Introducción: El asma es una de las principales causas de discapacidad y de mala calidad de vida a nivel mundial. El principal objetivo en el tratamiento es un buen control de la enfermedad, mejorar la calidad de vida y reducir el número de exacerbaciones. El tratamiento manual osteopático podría provocar cambios positivos en los volúmenes pulmonares. Hipótesis: La aplicación de terapia manual osteopática en el sujeto asmático produce cambios estadísticamente significativos sobre los valores espirométricos de la capacidad vital forzada (FVC), el volumen espiratorio forzado en el primer segundo (FEV1), la relación FEV1/FVC, el flujo espiratorio máximo o pico (PEF) y el cuestionario de calidad de vida MiniAQLQ. Objetivos: Determinar las posibles variaciones del FVC, FEV1, Coeficiente FEV1/FVC, PEF y cuestionario de calidad de vida MiniAQLQ, tras la aplicación de la terapia manual osteopática en el sujeto asmático. Material y Métodos: Se incluyeron 12 sujetos con asma intrínseco. Las variables analizadas fueron la FVC, el FEV1, el coeficiente FEV1/FVC, el PEF y el cuestionario de calidad de vida MiniAQLQ. El protocolo de intervención consta de 5 sesiones de tratamiento, compuestas cada una de ellas por 7 técnicas relacionadas con la patología, aplicadas en diferentes segmentos. Resultados: No hay efecto significativo de los tratamientos para la variable FVC, así como tampoco se objetiva efecto para la variable FEV1. No se evidencia efecto significativo para el Coeficiente FEV1/FVC. Los resultados obtenidos en la variable PEF demuestran un efecto significativo de los tratamientos 2, 3, 4 y 5 (p < 0.01). Existen cambios significativos en la escala de calidad de vida Mini-AQLQ en todas las dimensiones de la escala así como en la puntuación global. Conclusiones: La terapia manual osteopática produce cambios estadísticamente significativos en el PEF y la calidad de vida del sujeto asmático. No se objetivan cambios significativos para la FVC, FEV1 y Coeficiente FEV1/FVC, aunque se observa una ligera tendencia de mejoría para esta última variable (AU)

No disponible

Efectos de la técnica de Thumb-Move bilateral en ciclistas con posición adelantada de la cabeza / No disponible

Introducción: Gran número de estudios en los últimos años han establecido la relación entre una posición adelantada de la cabeza (PAC), respecto al raquis cervical, y diferentes patologías del aparato locomotor así como desequilibrios funcionales. Objetivos: Valorar los cambios inmediatos en dos medidas, post-intervención y quince minutos más tarde, obtenidos en el ángulo cráneo-vertebral (ángulo CV) después de la aplicación bilateral de la técnica de manipulación de C7/T1 (Thumb-Move), además de determinar los efectos en el rango de movimiento cervical, la fuerza de flexores y extensores cervicales, la fuerza prensil, la espirometría forzada y en los puntos gatillo de pectoral menor, trapecio superior y Esternocleidomastoideo (ECM). Material y métodos: Estudio experimental controlado aleatorizado, doble ciego. Participaron en el estudio cuarenta y un sujetos (n=41), todos ellos ciclistas, que presentaban PAC, grupo experimental (GE: n=24) y grupo control (GC: n=17). El GC recibe como placebo una técnica de ligera puesta en tensión, y el GE la técnica de Thumb-Move bilateral en C7. Se midieron todas las variables 3 veces, pre-intervención, post-intervención y 15 minutos más tarde. Resultados: El grupo experimental no obtuvo disminución significativa del ángulo cráneo-vertebral, ni variación significativa en ninguna de las otras variables medidas, salvo para la algometría de los puntos gatillo de los músculos ECM P=0,030 y Pectoral menor P=0,003 derechos. Conclusiones: La manipulación Thumb-Move bilateral de C7-D1, en ciclistas que presentan PAC), no modifica el ángulo CV en posición de sedestación o bipedestación. Ni tampoco modifica el rango de movimiento cervical, la fuerza prensil y la fuerza de flexores y extensores cervicales, ni los volúmenes espiratorios forzados

No disponible

Técnica de Thrust para la disfunción posterior de la cabeza del radio / Thrust technique for posterior disfunction of the radial head

Las disfunciones osteopáticas en el codo pueden causar absentismo laboral, con el gasto económico que ello conlleva para la sociedad, debido a la alta incidencia con la que estas disfunciones se presentan. Una de las lesiones osteopáticas que se pueden dar en el codo, es la disfunción de cabeza de radio posterior, que provoca un aumento del tono del músculo supinador corto, que a su vez puede referir dolor en la región externa del brazo y antebrazo. El objetivo de la técnica de thrust para la cabeza de radio posterior con contacto indexial, será anteriorizar la cabeza del radio, para así poder recuperar la funcionalidad en la articulación del codo. Para realizar correctamente la técnica, previamente habrá que llegar a un diagnóstico adecuado basado en la inspección, palpación, pruebas de movilidad, pruebas musculares, pruebas ortopédicas y radiología (AU)

Osteopathic dysfunctions in the elbow can cause work absenteeism, and the economic expense that this entails for society, due to the high incidence with which these dysfunctions occur. One of the osteopathic injuries that can occur in the elbow is posterior radial head dysfunction, which causes an increase in tone of the short supinator muscle, which in turn may refer pain in the external region of the arm and forearm. The objective of the thrust technique for the posterior radial head with indexial contact will be to forward the radial head in order to recover the functionality at the elbow joint. In order to correctly perform the technique, a proper diagnosis based on inspection, palpation, mobility tests, muscle tests, orthopedic tests and radiology must be previously arrived at (AU)

Técnica de Thrust para la disfunción de la cabeza humeral en superioridad / Thrust technique for the dysfunction of the humeral head in superiority

Las disfunciones en el hombro tienen una alta incidencia en lapoblación, entendiendo por hombro, el complejo articular compuesto de cinco articulaciones, entre la que cabría destacar, la articulación glenohumeral. Una de las lesiones más invalidantes de la articulación glenohumeral es la lesión de superioridad, debido a la estenosis del espacio subacromial que ésta provoca. El objetivo de la técnica de thrust para superioridad de la cabeza humeral será provocar el descenso de la cabeza humeral para recuperar la funcionalidad de la articulación gleno-humeral. Para realizar correctamente la técnica, previamente habría que aplicar un diagnóstico adecuado, basado en la inspección, palpación, pruebas de movilidad, pruebas musculares, pruebas ortopédicas y radilógicas. Este procedimiento tiene riesgos conocidos que deberán evitarse para obtener los beneficios terapéuticos deseados, en los pacientes que presenten indicaciones para su aplicación (AU)

Shoulder dysfunctions are very common in the population. By shoulder, one understands joint complex composed of five joints, among which one could highlight the gleno-humeral joint. One of the more incapacitating injuries of the gleno-humeral joints is the injury in superiority due to the stenosis of the subacromial space that this would cause. The aim of the thrust technique for superiority of the humeral head will be to cause the decline of the humeral head to regain functionality of the gleno-humeral joint. To successfully carry out the technique, it would be necessary to previously perform an appropriate diagnostic, based on inspection, palpation, mobility tests, muscle testing, orthopedic and x ray tests. This procedure has known risks that must be avoided to obtain desired therapeutic benefits in patients presenting indications for application (AU)

Aprendizaje en la Universidad: desafios para el siglo XXI. Del enfasis en los productos al enfasis en los procesos / Learning at the University: Callenges for the XXIst. century. From the emphasis on products to the emphasis on processes

Se revisan los planteamientos mas básicos de los principales paradigmas psicológicos y su impacto sobre el aprendizaje. A partir de un conjunto de referencias y reflexiones sobre la educación superior (particularmente en Venezuela) se discute la necesidad de cambio en la praxis educativa universitaria. Se observan deficiencias en la ejecución actual de los estudiantes universitarios de pregrado, tanto al inicio como al final de sus estudios, deficiencias que el autor atribuye a la prevalencia del modelo asociacionista del aprendizaje. Si bien se considera que existen cambios en el campo teórico-reflexivo orientados por los aportes cognitivos y constructivistas, creemos que falta mucho trabajo y reflexión para llevar estos aportes al aula universitaria. Finalmente en función de lo expuesto, se presentan algunas reflexiones orientadas a un modelo de aula universitaria en el cual se pase del énfasis en los productos al énfasis en los procesos. Esto se considera como un reto para el siglo XXI.