Tackling the challenge of peer learning in hybrid and online universities.

Peer learning is not fully developed or researched in online and hybrid higher education. This research analyses a peer learning experience in the asynchronous part of hybrid teaching, in one of the largest blended universities in Europe, promoting students to act as teachers of their peers, by preparing digital content (videos) for the course. This article studies whether there are behaviour patterns and different perceptions associated between students who act as teachers, and those who only act as students. The results indicate, among other findings, that students demand this type of activities, and value them very positively. Specifically, the "teachers" consider that this activity increases their motivation for the subject and their performance; they also consider that it significantly improves their creativity and communication skills, and they would definitely participate in the project again. The assessment of the students who merely view the materials is also very positive, and they prefer a learning method through classmate videos than the traditional learning method with printed materials. The research is also a boost to finding ways to promote learning among equals in non-classroom teaching in digital environments.

Structure-aware parametric representations for time-resolved light transport.

Time-resolved illumination provides rich spatiotemporal information for applications such as accurate depth sensing or hidden geometry reconstruction, becoming a useful asset for prototyping and as input for data-driven approaches. However, time-resolved illumination measurements are high-dimensional and have a low signal-to-noise ratio, hampering their applicability in real scenarios. We propose a novel method to compactly represent time-resolved illumination using mixtures of exponentially modified Gaussians that are robust to noise and preserve structural information. Our method yields representations two orders of magnitude smaller than discretized data, providing consistent results in such applications as hidden-scene reconstruction and depth estimation, and quantitative improvements over previous approaches.

Guía de práctica clínica: tamizaje, diagnóstico y manejo de episodios agudos y profilaxis del angioedema hereditario ­ Parte I: Enfoque diagnóstico / Clinical practice guidelines: screening, diagnosis and management of acute events and prophylaxis of hereditary angioedema ­ Part I: Diagnostic approach

El angioedema hereditario (AEH) es una enfermedad genética rara, con una prevalencia aproximada entre 1 por cada 50.000 habitantes, caracterizada por episodios de edemas a nivel subcutáneo y de mucosas (abdominal, genitourinario, respiratoria), siendo potencialmente mortal cuando hay afectación de la laringe. En Perú se estiman 600 pacientes con AEH. El AEH se puede clasificar del siguiente modo: con deficiencia del inhibidor de C1 (tipos I y II), y sin deficiencia del inhibidor de C1 (denominado anteriormente tipo III). El diagnóstico de laboratorio incluye prueba de complemento C4, prueba cuantitativa y cualitativa para inhibidor de C1 esterasa, y estudios genéticos.

Hereditary angioedema (HAE) is a genetic rare disease with a prevalence of approximately 1 per 50,000 inhabitants, characterized by episodes of edema at the subcutaneous level and mucous membranes (abdominal, genitourinary, respiratory), being potentially fatal when there is involvement of the larynx. In Peru, there are an estimated 600 patients with HAE. HAE can be classified as follows: with C1 inhibitor deficiency (types I and II), and without C1 inhibitor deficiency (previously called type III). Laboratory diagnosis includes C4 complement test, quantitative and qualitative tests for C1 inhibitor esterase, and genetic studies. In this first part of the Clinical Practice Guide, we present the recommendations for the diagnostic approach of HAE.

Guía de práctica clínica: tamizaje, diagnóstico y manejo de episodios agudos y profilaxis del angioedema hereditario ­ Parte II: Manejo y tratamiento / Clinical practice guidelines: screening, diagnosis and management of acute events and prophylaxis of hereditary angioedema ­ Part II: Management and treatment

El angioedema hereditario (AEH) es una enfermedad genética rara, con una prevalencia aproximada entre 1 por cada 50.000 habitantes, caracterizada por episodios de edemas a nivel subcutáneo y de mucosas (abdominal, genitourinario, respiratoria), siendo potencialmente mortal cuando hay afectación de la laringe. En Perú se estiman 600 pacientes con AEH. El AEH se puede clasificar del siguiente modo: con deficiencia del inhibidor de C1 (tipos I y II), y sin deficiencia del inhibidor de C1 (denominado anteriormente tipo III). El diagnóstico de laboratorio incluye prueba de complemento C4, prueba cuantitativa y cualitativa para inhibidor de C1 esterasa, y estudios genéticos. Existen tratamientos específicos a nivel mundial para crisis agudas y profilaxis en AEH. Sin embargo, en Perú el único tratamiento registrado actualmente es el ecallantide, útil en crisis agudas; además, podemos utilizar tratamientos alternativos como el ácido tranexámico y el danazol. En esta segunda parte de la Guía de Práctica Clínica, presentamos las recomendaciones para el manejo y el tratamiento del AEH.

Hereditary angioedema (HAE) is a genetic rare disease with a prevalence of approximately 1 per 50,000 inhabitants, characterized by episodes of edema at the subcutaneous level and mucous membranes (abdominal, genitourinary, respiratory), being potentially fatal when there is involvement of the larynx. In Peru, there are an estimated 600 patients with HAE. HAE can be classified as follows: with C1 inhibitor deficiency (types I and II), and without C1 inhibitor deficiency (previously called type III). Laboratory diagnosis includes C4 complement test, quantitative and qualitative test for C1 inhibitor esterase, and genetic studies. There are specific treatments worldwide for acute crises and prophylaxis in HAE; in Peru the only currently registered treatment is ecallantide, useful in acute crises; we can also use alternative treatments such as tranexamic acid and danazol. In this second part of the Clinical Practice Guide, we present the recommendations for the management and treatment of HAE.

Compression and denoising of time-resolved light transport.

Exploiting temporal information of light propagation captured at ultra-fast frame rates has enabled applications such as reconstruction of complex hidden geometry and vision through scattering media. However, these applications require high-dimensional and high-resolution transport data, which introduces significant performance and storage constraints. Additionally, due to different sources of noise in both captured and synthesized data, the signal becomes significantly degraded over time, compromising the quality of the results. In this work, we tackle these issues by proposing a method that extracts meaningful sets of features to accurately represent time-resolved light transport data. Our method reduces the size of time-resolved transport data up to a factor of 32, while significantly mitigating variance in both temporal and spatial dimensions.

The monocyte locomotion inhibitory factor inhibits the expression of inflammation-induced cytokines following experimental contusion in rat tibia.

Entamoeba histolityca produces the monocyte locomotion inhibitory factor (MLIF), a pentapeptide with powerful anti-inflammatory properties. MLIF may regulate trauma-induced inflammation through the effects it exerts directly or indirectly on immune cells, modulating the production and/or expression of the cytokines involved in the inflammatory processes that occur after damage. The aim of the present study was to evaluate the effect of MLIF on production of pro/anti-inflammatory cytokines after contusion in the rat tibia. Fifty-four Wistar rats were subjected to controlled contusion with a special guillotine-type device, and 36 rats were injected with MLIF or tenoxicam into the tibia. Eighteen animals received saline; the animals were sacrificed 24 or 48 hours after injection. Cytokine mRNA and protein production were determined by reverse transcriptase-polymerase chain reaction (RT-PCR), immunofluorescence, and hematoxylin-eosin staining was performed to visualize cellular infiltration in the rats' injured tissue. Expression levels of the cytokines interferon gamma (IFN-γ), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and transforming growth factor-beta (TGF-ß) mRNA were inhibited significantly by MLIF at 24 hours post-contusion. MLIF significantly increased the expression levels of IL-10 at 24 hours compared with tenoxicam or the control group. These changes were associated with a significant decrease in protein production levels of TNF-α, IFN-γ, IL-6 and TGF-ß at 24 hours. Histological evaluation showed the presence of infiltration by neutrophils, monocytes and leucocytes in control tissues. This infiltration was decreased after MLIF administration, and intense infiltration was observed in tenoxicam-treated group. MLIF inhibited the expression of pro-inflammatory cytokines and increased the expression of anti-inflammatory cytokine IL-10.

Hemorragia alveolar difusa como forma de presentación de lupus eritematoso sistémico asociado a tiroiditis autoinmune

El lupus eritematoso sistémico es una enfermedad inflamatoria crónica de naturaleza autoinmune, de etiología desconocida en la que hay daño celular y tisular por autoanticuerpos y que cursa con un amplio espectro de manifestaciones clínicas. La hemorragia alveolar difusa es una forma de presentación poco frecuente en pacientes con lupus eritematoso sistémico, raramente debuta como una manifestación inicial de la enfermedad. Aproximadamente 2 % de todos los pacientes con lupus eritematoso sistémico presentan este cuadro, siendo su asociación con otras enfermedades de origen inmune, entre ellas la tiroiditis autoinmune un caso excepcional con elevada mortalidad

Systemic lupus erythematosus is a chronic inflammatory disease of autoimmune nature of unknown etiology in which there is cell and tissue damage that causes autoantibodies and a broad spectrum of clinical manifestations. Diffuse alveolar hemorrhage is a rare presentation in patients with Systemic lupus erythematosus, rarely it debuts as an initial manifestation of the disease. Approximately 2 % of all patients with Systemic lupus erythematosus have this disease, and its association with other immune-mediated diseases including autoimmune thyroiditis an exceptional case with high mortality

Síndrome de Evans en paciente con síndrome antifosfolipídico secundario: Desafío terapéutico

El síndrome de Evans, es caracterizado por la presencia de anemia hemolítica autoinmune y púrpura trombocitopénica, presentándose con menor frecuencia en pacientes con diagnóstico de lupus eritematoso sistémico. La asociación de estas dos entidades con el síndrome de anticuerpos antifosfolípidos se torna inusual, constituyendo un desafío diagnóstico y a la vez terapéutico para el clínico. Presentamos un paciente con lupus eritematoso sistémico, que desarrollo síndrome de Evans y síndrome antifosfolípido, complicado con hemorragia intracerebral cisternal y trombosis venosa profunda de miembros superiores

Evans syndrome is characterized by the presence of autoimmune hemolytic anemia and thrombocytopenic purpura, appearing less frequently in patients with systemic lupus erythematosus. The association of these two entities with antiphospholipid antibody syndrome becomes unusual, constituting a diagnostic challenge and therapeutic. We present a patient with systemic lupus erythematosus who developed Evans syndrome and antiphospholipid syndrome, complicated with cerebral haemorrhage and deep venous thrombosis of upper limbs

Paresia ascendente como comienzo de inusual asociación entre miopatía autoinmune necrosante y lupus eritematoso sistémico / Ascending paresis as presentation of an unusual association between necrotizing autoimmune myopathy and systemic lupus erythematosus

El paciente, un hombre de 45 a˜nos de edad, ingresó a Emergencias debido a un padecimiento actual que inició 15 días antes de forma insidiosa y curso progresivo. Comenzó con debilidad simétrica y dolor en los pies y los tobillos, que se extendió hacia arriba hasta las rodillas. Más tarde, el dolor progresó a paraparesia, mostrando niveles de creatincinasa de 44.270 U/L e insuficiencia respiratoria que requirió ventilación mecánica. Se llevaron a cabo una electromiografía y un biopsia muscular del cuádriceps. El paciente respondió a la corticoterapia en pulsos y a manejo de soporte. La presentación de parálisis ascendente sugirió el diagnóstico de síndrome de Guillain-Barré; sin embargo, el grado de afectación e los músculos con rabdomiólisis explicó el da˜no neurológico por sí mismo. La biopsia reveló criterios patológicos para miopatía necrosante autoinmune (MNA), así como otros datos clínicos y de laboratorio. Además, reunió criterios para clasificarse como lupus eritematoso sistémico (LES). De acuerdo con a literatura revisada, este es el primer reporte de la asociación entre MNA y LES (AU)

A 45 year-old man went to the emergency room due to disease duration of 15 days of insidious onset and progressive course. It began with symmetrical weakness and pain in feet and ankles that extends upward to the knees. Later, this progressed to paraparesis with Creatine phosphokinase levels of 44,270 U/L and respiratory failure that required mechanical ventilation. Electromyography and muscle biopsy of quadriceps were made. The patient responded to corticotherapy in pulses and supporting management. The presentation of ascending paresis suggested the diagnosis of Guillain-Barré syndrome. However, the degree of muscle involvement with rhabdomyolysis explains the neurological damage by itself. The biopsy revealed pathological criteria for necrotizing autoimmune miopathy (NAM), as well as other clinical and laboratory evidence. Patient disease continued and reached criteria for systemic lupus erythematosus (SLE). To our best knowledge, this is the first report of the NAM and SLE association (AU)

Ascending paresis as presentation of an unusual association between necrotizing autoimmune myopathy and systemic lupus erythematosus.

A 45 year-old man went to the emergency room due to disease duration of 15 days of insidious onset and progressive course. It began with symmetrical weakness and pain in feet and ankles that extends upward to the knees. Later, this progressed to paraparesis with Creatine phosphokinase levels of 44,270 U/L and respiratory failure that required mechanical ventilation. Electromyography and muscle biopsy of quadriceps were made. The patient responded to corticotherapy in pulses and supporting management. The presentation of ascending paresis suggested the diagnosis of Guillain-Barré syndrome. However, the degree of muscle involvement with rhabdomyolysis explains the neurological damage by itself. The biopsy revealed pathological criteria for necrotizing autoimmune myopathy (NAM), as well as other clinical and laboratory evidence. Patient disease continued and reached criteria for systemic lupus erythematosus (SLE). To our best knowledge, this is the first report of the NAM and SLE association.

¿Dosis bajas de bupivacaina subaracnoidea reducen la incidencia de hipotensión durante la cesárea? / Low dose of bupivacaina subaracnoidea reduce the incident of low blood pressure during the cesarean section?

El bloqueo subaracnoideo es una modalidad de anestesia usada con frecuencia para la realización de cesáreas. Entre los medicamentos utilizados para tal bloqueo, los anestésicos locales (específicamente la bupivacaína) y los opioides solos o combinados son los más frecuentes, con efectividad y seguridad probadas. Se propone cada vez con más frecuencia que las dosis de anestésicos locales sean menores, con el objeto de disminuir la incidencia de hipotensión materna uno de los efectos secundarios más frecuentes y menos deseados con esta técnica. Se tomaron 109 pacientes obstétricas sin patologías concomitantes, programadas para cesárea en la Clínica San Pedro Claver y se aleatorizaron para recibir 12.5 mg ó 7.5 mg de bupivacaína pesada, en todos los casos con 15 mg de fentanil intratecal, hipotetizando que dosis menores disminuirían la incidencia de hipotensión sin afectar la calidad de la anestesia colocada. Se encontró que la incidencia de hipotensión fue 68.6 por ciento en el grupo de 7.5 mg y de 72.4 por ciento en el grupo de 12.5 mg con un RR de 0.94 (IC95 por ciento 0.74 y 1.21). No se pudo demostrar diferencia entre el uso de una u otra dosis de medicamento en relación con la calidad de la anestesia y la aparición de efectos adversos. Se concluye que el uso de cualquiera de las dos dosis es efectivo y seguro en pacientes obstétricas...