La fragilidad en candidatos a trasplante renal

Frailty is a concept that has been mainly developed in geriatrics and it came from the need of identifying subjects at risk to develop complications when they faced a stressful event. Frail patients have higher risk of mortality, poor outcomes and disability, and this is independent from their age or comorbidities. Chronic kidney disease patients present with high prevalence of frailty, especially those who are in renal replacement therapy. Frail or pre-frail patients on the kidney transplant waiting list represent 20-30%, and these patients are proven to have poorer results after the transplant, which is a stressful event itself. Tools for frailty assessment, both scales or indexes, may be useful to identify which subjects might be at risk for complications after transplant, and this is necessary to adapt our clinical practice and minimize morbidity. The most used frailty scale in kidney patients is Fried scale, which is based in five phenotypic items. Besides that, knowing frail population allows potential interventions such as prehabilitation while the patient is waiting for the kidney transplant, which the aim of improving their vulnerability prior to transplant and, therefore, optimizing results after transplant. More studies are needed amongst kidney patients to improve and prevent frailty.     

Advanced Photonic Thin Films for Solar Irradiation Tuneability Oriented to Greenhouse Applications

The world population is growing by 1 billion people every 10 years. There will come a time when there will be more people to feed but less land to grow food. Greenhouses can be the solution to this problem because they provide the highest production yield per m² and also use less water, provide food safety, and offer high quality. Photosynthetic active radiation (PAR) favors vegetable growth with a specific blue and red light ratio. Thus, increasing the amount of red light improves chlorophyll absorption and photosynthetic efficiency. In this article, we present a hybrid system that combines luminescent materials and photonic crystals for better management of the light reaching the greenhouse. The luminescent dyes considered herein are combined ensuring a Förster resonance energy transfer (FRET) nonradiative mechanism to enhance the absorption range. The designed photonic crystal maximizes reflections in the Near-Infrared (NIR) range, and therefore, thermal losses are minimized. Thus, by converting harmful or ineffective radiation for plant growth to the PAR region, we aim to demonstrate growth-condition enhancement for the different vegetables that have been used as a model.     

Valoración por los estudiantes de la formación práctica de grado de Medicina. El caso de la Neumología

IntroductionPractical training for medical students is provided during the final years of study and is determined by several conditioning factors, including the MIR training that students receive simultaneously. In general, practical training evaluation receives much less attention than the theoretical one; its quality is not evaluated, and the professors do not receive feedback. The objective of our study was to determine how students value practical training in pulmonology rated the experience after completing a three-week rotation, in order to apply the information gained toward a process of continual improvement.MethodsThe study included 2 anonymous surveys taken by medical students during the same academic year-one internal, prepared by the Department of Pneumology, itself, and another external one, prepared by the Evaluation Unit for Teaching Excellence at the University of Salamanca.ResultsOn the internal evaluation, student opinions of their practical training ran high (8.26) and the perceived usefulness was also high (8.23), on a scale of 0 to 10 and no differences were noted according to whether the survey was taken during their fourth, fifth, or sixth year of study. These results agree with those obtained in the external evaluation with a mean value of 4.56 on a scale of 0 to 5. Student preferences during their rotation in the department were for hospitalization and consultation units, with the technical areas being lesser valued.ConclusionsAchieving and maintaining a high quality of practical training is a goal that should be consistently evaluated so that professors may receive feedback (internal and external). Rotations in the Department of Pneumology provide an opportunity to improve the perception that medical students have regarding this specialty. It is imperative to reflect upon the contents of these rotations, seeking a balance between clinical areas and technical areas.     

New era of personalized medicine: Advanced therapy medicinal products in Europe

Advanced therapy medicinal products are human medical therapies based on genes, cells, or tissues, and due to their characteristics, they offer new innovative opportunities for the treatment of diseases and injuries, especially for diseases beyond the reach of traditional approaches. These therapies are at the forefront of innovation and have historically been very controversial, although in the last decade they have gained prominence while the number of new advanced therapies has increased every year. In this regard, despite the controversy they may generate, they are expected to dominate the market in the coming decades. Technologies based on advanced therapies are the present and future of medicine and bring us closer to the long-awaited precision medicine. Here we review the field as it stands today, with a focus on the molecular mechanisms that guided the different advanced therapies approved by the European Medicines Agency, their current status, and their legal approval.