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BACKGROUNDWe evaluated the safety and viral rebound, after analytical treatment interruption (ATI), of vedolizumab and ART in recent HIV-1 infection. We used this model to analyze the effect of α4ß7 on the HIV-1 reservoir size.METHODSParticipants started ART with monthly vedolizumab infusions, and ATI was performed at week 24. Biopsies were obtained from ileum and cecum at baseline and week 24. Vedolizumab levels, HIV-1 reservoir, flow cytometry, and cell-sorting and antibody competition experiments were assayed.RESULTSVedolizumab was safe and well tolerated. No participant achieved undetectable viremia off ART 24 weeks after ATI. Only a modest effect on the time to achieve more than 1,000 HIV-1 RNA copies/mL and the proportion of participants off ART was observed, being higher in the vedolizumab group compared with historical controls. Just before ATI, α4ß7 expression was associated with HIV-1 DNA and RNA in peripheral blood and with PD1 and TIGIT levels. Importantly, a complete blocking of α4ß7 was observed on peripheral CD4+ T cells but not in gut (ileum and cecum), where α4ß7 blockade and vedolizumab levels were inversely associated with HIV-1 DNA.CONCLUSIONOur findings support α4ß7 as an important determinant in HIV-1 reservoir size, suggesting the complete α4ß7 blockade in tissue as a promising tool for HIV-cure combination strategies.TRIAL REGISTRATIONClinicalTrials.gov NCT03577782.FUNDINGThis work was supported by the Instituto de Salud Carlos III (Fondo Europeo de Desarrollo Regional, "a way to make Europe," research contracts FI17/00186 and FI19/00083 and research projects PI18/01532, PI19/01127, PI22/01796), Conserjería de Economía, Conocimiento, Empresas y Universidad, Junta de Andalucía (research projects P20/00906), the Red Temática de Investigación Cooperativa en SIDA (RD16/0025/0020), and the Spanish National Research Council.
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Anticuerpos Monoclonales Humanizados , Infecciones por VIH , VIH-1 , Carga Viral , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Fármacos Anti-VIH/administración & dosificación , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/administración & dosificación , Linfocitos T CD4-Positivos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , VIH-1/efectos de los fármacos , Íleon/metabolismo , Íleon/virología , Integrinas/metabolismo , ARN Viral/sangre , Carga Viral/efectos de los fármacosRESUMEN
Abstract: Introduction: Although the training of nurses in administration and leadership has an important repercussion on the present and the future of the profession, teaching methods are still traditional in many cases. Flipped classroom is a widely used method in nursing education but studies about its application to Nursing Administration and Management are limited. Method: Qualitative study by means of anonymous survey (dichotomous and open questions). Results: 92 % of students were shown to be satisfied with the teaching methodology and 92.9 % with the assessment. Only 31.5 % had used it previously but 83 % would like to use it in more subjects. The students showed that the methodology used had improved their opinion about the content and had increased their perception its usefulness. Conclusion: The participating students have been shown to be satisfied with flipped method and continuous assessment. These teaching strategies can help motivate nursing students towards the subject of Nursing Administration and Management, which can encourage them to pursue postgraduate training and professional practice in this area
Resumen: Introducción: Si bien la formación de enfermeros en Administración y Gestión tiene una importante repercusión en el presente y el futuro de la profesión, los métodos de enseñanza siguen siendo tradicionales en muchos casos. El aula invertida es un método ampliamente utilizado en la educación de enfermería, pero los estudios sobre su aplicación a la administración y gestión de enfermería son limitados. Método: Estudio cualitativo mediante cuestionario anónimo (preguntas dicotómicas y abiertas). Resultados: El 92 % de los estudiantes se mostró satisfecho con la metodología de enseñanza y el 92,9 % con la evaluación. Solo el 31,5 % lo había usado anteriormente, pero al 83 % le gustaría usarlo en más sujetos. Los estudiantes demostraron que la metodología utilizada había mejorado su opinión sobre el contenido y había aumentado su percepción útil del mismo. Conclusión: Los estudiantes participantes han demostrado estar satisfechos con el método de aula invertida. Estas estrategias de enseñanza pueden ayudar a motivar a los estudiantes de enfermería hacia la asignatura de Administración y Gestión de los Servicios de Enfermería, lo que puede animarlos a realizar una formación de posgrado y una práctica profesional en esta área.
Resumo: Introdução: Embora a educação de Enfermagem em Administração e Gestão tenha um grande impacto no presente e futuro da profissão, os métodos de ensino continuam a ser tradicionais em muitos casos. A sala de aula invertida é um método amplamente utilizado na educação em Enfermagem, mas os estudos sobre a sua aplicação à Administração e Gestão de Enfermagem são limitados. Método: Estudo qualitativo utilizando um questionário anônimo (perguntas dicotômicas e abertas). Resultados: 92% dos estudantes ficaram satisfeitos com a metodologia de ensino e 92,9% com a avaliação. Apenas 31,5% já o tinha utilizado antes, mas 83% gostariam de utilizá-lo em mais assuntos. Os estudantes mostraram que a metodologia utilizada havia melhorado a sua opinião sobre o conteúdo e aumentado a sua percepção útil do conteúdo. Conclusão: Os estudantes participantes mostraram-se satisfeitos com o método invertido e com a avaliação contínua. Estas estratégias de ensino podem ajudar a motivar os estudantes de Enfermagem para a disciplina de Administração e Gestão de Enfermagem, o que pode encorajá-los a empreender uma educação de pós-graduação e prática profissional nesta área.
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Introducción: La formación de las enfermeras en administración y liderazgo tiene una importante repercusión sobre el presente y el futuro de la profesión. Sin embargo, la docencia y la evaluación realizadas en el nivel de pregrado, en su primer contacto con la materia, pueden generarles insatisfacción. Objetivo: Describir las percepciones de estudiantes de Enfermería sobre una innovación docente basada en el uso del "Libro" de Moodle como herramienta pedagógica, dentro de un enfoque general de clase invertida. Métodos: Estudio mixto exploratorio, realizado entre octubre y diciembre de 2020 en la Universidad de Huelva (España), mediante encuesta anónima sobre una muestra de 140 alumnos (del total de 145 estudiantes del 3º curso). Los datos fueron procesados en Excel y analizados de forma descriptiva (datos cuantitativos) y por categorías (datos cualitativos). Resultados: La valoración media del uso de la herramienta "Libro" fue de 9,10 sobre 10. El 92,00 por ciento de los estudiantes se mostró satisfecho con la metodología de enseñanza y 92,90 por ciento con la evaluación. Los estudiantes manifestaron haber mejorado su opinión sobre los contenidos gracias a la metodología empleada. Conclusión: La mayoría de los estudiantes participantes en este estudio se han mostrado satisfechos con el uso de la herramienta de Moodle dentro de un contexto de docencia a través de clase invertida(AU)
Introduction: The training of nurses in management and leadership has an important impact on the present and future of the profession. However, the teaching and evaluation carried out in the undergraduate level, in their first contact with the subject, can generate dissatisfaction. Objective: To describe the perceptions of students of Nursing Administration and Management regarding a teaching innovation based on using the "Libro" tool in the framework of teaching by means of a flipped classroom. Methods: Exploratory and mixed study carried out between October and December 2020 at the University of Huelva, Spain, by means of an anonymous survey conducted with a sample of 140 students (of the total of 145 students from the third academic year). The data were processed in Excel and analyzed descriptively (quantitative data) and by categories (qualitative data). Results: The average evaluation of using the "Libro" tool was 9.10 out of 10. 92.00 percent of the students were satisfied with the teaching methodology and 92.90 percent were satisfied with the evaluation. The students stated that their opinion of the contents had improved thanks to the methodology used. Conclusion: Most of the students participating in this study were satisfied with the use of the Moodle tool within a teaching setting of flipped classroom(AU)
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Humanos , Percepción , Estudiantes de Enfermería , Investigación en Educación de Enfermería/métodos , Bibliotecas Digitales , Satisfacción Personal , Metodología como un TemaRESUMEN
INTRODUCTION: Different organizations have recommended changes in life support in the COVID-19 pandemic, just when maintaining the competence in cardiopulmonary resuscitation is compromised because on-site training must be avoided. We developed a pilot teaching-learning experience to promote cardiopulmonary resuscitation skills acquisition in this situation. The aim of this study was to describe that tool and to analyze its usefulness. METHODS: The experience consisted of three phases: first, reviewing the scientific literature; second, defining written local recommendations and recording a short video simulating the initial attention to a cardiac arrest in this COVID-19 context; third, creating a test to be answered by hospital health professionals. RESULTS: The final sample was 121 subjects; 66.1% were women; the mean age was 45.8 years (SD = 10.24). Among them, 43% were doctors, 43% nurses, 4.1% nursing assistants, and 9.9% others. 89.3% participants had received prior training in life support. In the test, questions 1, 2, 5, 6, 7, and 8 were answered correctly by more than 80%; questions 3 and 4 were answered correctly by 57.9% and 41.3%, respectively. All participants expressed that the video helped them to refresh their knowledge and skills in life support. DISCUSSION: When on-site training is not possible, distance learning-as in our teaching-learning innovation because of the COVID-19 pandemic-may be a valid option to acquire/refresh cardiopulmonary resuscitation skills.
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COVID-19 , Reanimación Cardiopulmonar , Paro Cardíaco , COVID-19/epidemiología , Reanimación Cardiopulmonar/educación , Competencia Clínica , Femenino , Paro Cardíaco/terapia , Humanos , Masculino , Persona de Mediana Edad , PandemiasRESUMEN
CONTEXT: Growing evidence suggests that prenatal exposure to methyl mercury through the maternal diet could have great influence on the neurological and physical development of neonates and young children. OBJECTIVE: The aim of this review was to evaluate the clinical repercussions of maternal exposure to methyl mercury during pregnancy on the health of fetuses, neonates, and children up to 8 years of age. DATA SOURCES: The Web of Science, PubMed, CINAHL, Scopus, and Dialnet Plus databases were searched for articles published in English or Spanish from 1990 to 2020. STUDY SELECTION: Original articles published in English or Spanish from 1990 to 2020 were eligible for inclusion. All study designs were eligible. Animal studies were excluded. Two authors independently screened studies for inclusion. From the 971 records initially identified, 19 studies were included in the systematic review. DATA EXTRACTION: PRISMA guidelines were followed. Outcomes extracted included maternal dietary exposure to methyl mercury during pregnancy, possible health repercussions in offspring up to 8 years of age, and quantitative measurement of mercury in a biological sample. All studies met the requirements established for assessing both study quality and risk of bias. RESULTS: Prenatal exposure to mercury was consistently associated with lower birth weight, but only one study reported a negative association with length at birth. Higher mercury levels were also related to lower scores in various neuropsychological and developmental tests. CONCLUSION: The literature shows clear evidence of the adverse effects of maternal methyl mercury exposure on anthropometric variables and cognitive or physical development in children. It is noteworthy, however, that mercury toxicity may sometimes be mitigated by other essential nutrients in the maternal diet, such as polyunsaturated fatty acids.