María Luisa Sevillano García

Bio: María Luisa Sevillano García is an academic researcher from National University of Distance Education. The author has contributed to research in topics: Liver transplantation & Cirrhosis. The author has an hindex of 13, co-authored 92 publications receiving 477 citations.

Integración de tecnologías de la información y comunicación en educación infantil en Navarra

Abstract: El articulo ofrece una perspectiva sobre integracion, dificultades, causas y resultados sobre las TIC enEducacion Infantil en la Comunidad Foral de Navarra, a partir de estudios, percepciones, experiencias dedocentes de esta etapa, opiniones de expertos y familias. Es un estudio analitico y prospectivo conimportantes aportaciones valiosas sobre formacion inicial y permanente del profesorado, dotacion decentros y aulas, mantenimiento de tecnologias, personal especializado de apoyo. Administracion educativa,familias y docentes son interpeladas. Por la fiabilidad de los instrumentos y analisis realizados losresultados son extrapolables a otras comunidades, profesorado y realidades educativas.

Impact of hepatitis C virus (HCV) antiviral treatment on the need for liver transplantation (LT).

Abstract: Background Therapies for hepatitis C virus (HCV) infection have revolutionized the treatment of patients with chronic HCV infection. The effect of these therapies on the epidemiology of liver transplantation (LT) has yet to be elucidated. Aim To establish whether the indications for LT have changed as a result of the introduction of new therapies for HCV. Materials and Methods We conducted a retrospective study based on a prospectively maintained registry of patients who undergo LT at La Fe Hospital in Valencia from 1997 to 2016. An analysis of outcome measures over time stratified by LT indications was performed. Results From January 1997 to December 2016, 2379 patients were listed for LT. Of these, 1113 (47%) were listed for HCV cirrhosis ± hepatocellular carcinoma (HCC). This percentage varied significantly over time declining from 48.8% in the 1997-2009 initial period (IFN-based regimens) to 33% in the 2014-2016 final period (DAAs regimens) (p=0.03). However, during that period, the proportion of those included in the waiting list (WL) due to HCV-HCC increased significantly (p=0.001). In addition, among HCV-positive waitlisted patients with decompensated cirrhosis without HCC, the proportion of those with an HCV-alcohol mixed etiology also increased significantly over time (p=0.001). Of all HCV-positive waitlisted patients, 203 were eventually removed from the WL due to either clinical improvement (n=77) or more frequently worsening/death (n=126). Conclusions The proportion of patients wait-listed for LT for decompensated HCV cirrhosis has significantly decreased over time. These changes are possibly related to the large-scale use of direct-acting antivirals. This article is protected by copyright. All rights reserved.

Aplicación del juego ubicuo con realidad aumentada en Educación Primaria

Abstract: Augmented reality (AR) immersion enables virtual objects and real environments to coexist and encourage experimentation with phenomena that are not possible in the real world. Augmented reality is generating new opportunities for the development of ubiquity within educational environments. The objective of this study was to analyze the impact that the integration of ubiquitous game approaches with augmented reality has on learning. A quasi-experimental study was carried out with 91 sixth-grade primary school students; the learning scenario was designed and the augmented reality application “WallaMe” was selected for use in five sessions of a didactic unit in Art Education. Through pretest and posttest procedures, academic performance and information search skills were evaluated, and, a Likert scale analyzed the motivation and collaboration variables among the students. The results showed that the experimental group obtained statistically significant improvements in the academic performance of the subject, motivation, in the search for, and analysis of, information, level of fun and collaboration. The conclusion is that the dynamic activities managed in the intervention, which made use of augmented reality and localization, benefit teaching-learning processes, and encourage innovation and improvement through educational technology.

Competencias necesarias para la utilización de las principales herramientas de Internet en la educación

Abstract: espanolEn el marco del Espacio Europeo de Educacion Superior (EEES) se incluye el desarrollo de competencias transversales, de formacion disciplinar y profesional desde disenos abiertos. Por ello, la finalidad principal de este trabajo es conocer la percepcion que tienen los estudiantes de las carreras de educacion, como agentes implicados en la configuracion del EEES, sobre la tipologia de competencias que han de desarrollar para la utilizacion de las herramientas de Internet en el ambito profesional. El trabajo presentado se encuadra en el enfoque naturalista a traves de la tecnica del grupo de discusion. Desde este enfoque, se ha enfatizado la importancia dada a las aportaciones de los participantes, las evidencias obtenidas y la tipologia de analisis de contenido aplicado. En el estudio han participado 53 personas a traves de 11 grupos de discusion, desarrollando el debate e indagando sobre los topicos centrales de la investigacion abordada. Como hallazgos hay que destacar que las principales herramientas de Internet aplicadas a la educacion (paginas web, p2p, e-mail, foros, chat/messenger, videoconferencia/VOIP, edublog y webquest) requieren del dominio de competencias basicas de tipo informatico y de un desarrollo especializado en funcion de la aplicacion virtual, asi como de otras habilidades y conocimientos propios de este escenario y del ambito profesional. La competencia comunicativa se considera como fundamental para la utilizacion de las herramientas de Internet, asi como la de organizacion y planificacion, con el objeto de poder realizar la interpretacion de significados y el intercambio entre los usuarios. Es en este escenario en el que existe una elevada exigencia para desarrollar la competencia tecnologica con los estudiantes de las titulaciones de educacion, de la que estos son conscientes, cuando las TIC estan llamadas a protagonizar un papel primordial como medios de aprendizaje y como recursos valiosos para el ejercicio profesional. EnglishThe European Higher Education Area framework includes the development of transversal competences, competences for learning a discipline and professional competences in open designs. The main purpose of this paper is to ascertain how university students of education, as parties involved in the configuration of the EHEA, perceive the types of competences they must develop in order to use Internet tools in their career. The paper is based on a naturalistic approach using the discussion group. This approach is used to emphasize the importance assigned to the participants� contributions, the evidence found and the type of content analysis applied. The study involved 53 people in 11 discussion groups that discussed and inquired into the central research issues. The leading findings are that the main Internet tools for education (web pages, P2P, email, forums, chat/IM, video conferencing/VoIP, Edublog and WebQuest) require basic computer science competences and some specialization in virtual tools, as well as other skills and knowledge related to the Internet setting and the career field. Communicative competence is seen as fundamental for using Internet tools, as is competence in organization and planning, in order to interpret meanings and user exchanges. Information and communication technologies have a special starring role as the primary means for learning and as valuable resources later in the workplace. This is the setting, where students seeking education degrees have to meet a high demand for technological competence, and they know it.

Posibilidades formativas mediante nuevos escenarios virtuales

Abstract: La presencia de tecnologias en todos los campos de la vida afecta a las formas de actuar pedagogico en todas las situaciones vitales y a cualquier edad. Las posibilidades interactivas inherentes a las nuevas herramientas virtuales estan generando un desplazamiento del papel hegemonico del emisor en los clasicos paradigmas de la comunicacion, para abrirse a los receptores, haciendo mas compleja la funcion del canal y los codigos y posibilitando la creacion de comunidades virtuales. Conocer su existencia, usos y repercusion en los nuevos modos de aprendizaje ha sido mi empeno en el trabajo que posibilito este estudio. Este articulo quiere mostrar posibilidades y limitaciones de los recursos utilizados y analizados en la experimentacion, potenciar el uso de tecnologias para desarrollar nuevos entornos de aprendizaje independiente y cooperativo, que refuercen el desarrollo de la creatividad, la autoestima y el pensamiento critico. Se ha detectado una alta participacion especialmente de la comunidad virtual estudiada. Se han verificado multiples e innovadoras fomas de ayuda reciproca, asi como el senalamiento de nuevos horizones en la busqueda de aprendizajes colaborativos e innovadores en cuanto a las formas y estrategias. Se ha constatado tambien un creciente interes por la interconexion e interrelacion tanto de centros como de estudiantes, profesores de apoyo y equipos directivos. Implicaciones en las practicas educativas: - Cualificacion pedagogica permanentemente actualizada del profesorado. - Adaptacion diferenciada para incluir todos los sujetos, en funcion de sus necesidades y demandas. - Desvanecimiento de fronteras y distancias, en cuanto que los nuevos medios telematicos permiten la ensenanza superando el concepto del espacio e incluso del tiempo. - Integracion de nuevas relaciones entre emisores, receptores y mensajes. - El nuevo modelo de ensenanza y aprendizaje podria implicar una atencion a la adquisicion de nuevas competencias en profesores y alumnos.

Ledipasvir and Sofosbuvir Plus Ribavirin for Treatment of HCV Infection in Patients With Advanced Liver Disease

Abstract: Background & Aims There are no effective and safe treatments for chronic hepatitis C virus (HCV) infection of patients who have advanced liver disease. Methods In this phase 2, open-label study, we assessed treatment with the NS5A inhibitor ledipasvir, the nucleotide polymerase inhibitor sofosbuvir, and ribavirin in patients infected with HCV genotypes 1 or 4. Cohort A enrolled patients with cirrhosis and moderate or severe hepatic impairment who had not undergone liver transplantation. Cohort B enrolled patients who had undergone liver transplantation: those without cirrhosis; those with cirrhosis and mild, moderate, or severe hepatic impairment; and those with fibrosing cholestatic hepatitis. Patients were assigned randomly (1:1) to receive 12 or 24 weeks of a fixed-dose combination tablet containing ledipasvir and sofosbuvir, once daily, plus ribavirin. The primary end point was sustained virologic response at 12 weeks after the end of treatment (SVR12). Results We enrolled 337 patients, 332 (99%) with HCV genotype 1 infection and 5 (1%) with HCV genotype 4 infection. In cohort A (nontransplant), SVR12 was achieved by 86%–89% of patients. In cohort B (transplant recipients), SVR12 was achieved by 96%–98% of patients without cirrhosis or with compensated cirrhosis, by 85%−88% of patients with moderate hepatic impairment, by 60%–75% of patients with severe hepatic impairment, and by all 6 patients with fibrosing cholestatic hepatitis. Response rates in the 12- and 24-week groups were similar. Thirteen patients (4%) discontinued the ledipasvir and sofosbuvir combination prematurely because of adverse events; 10 patients died, mainly from complications related to hepatic decompensation. Conclusion The combination of ledipasvir, sofosbuvir, and ribavirin for 12 weeks produced high rates of SVR12 in patients with advanced liver disease, including those with decompensated cirrhosis before and after liver transplantation. ClinTrials.gov: NCT01938430.

Subacute Thyroiditis After Sars-COV-2 Infection.

Abstract: Context Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak. Objectives The objective of this work is to report the first case of SAT related to SARS-CoV-2 infection. Methods We describe the clinical, laboratory, and imaging features of an 18-year-old woman who came to our attention for fever, neck pain radiated to the jaw, and palpitations occurring 15 days after a SARS-CoV-2-positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patient had completely recovered in a few days. Results At physical examination the patient presented with a slightly increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams free thyroxine and free triiodothyronine were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging both were normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within 2 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in 40 days. Conclusions We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.

Impact of DAAs on liver transplantation: Major effects on the evolution of indications and results. An ELITA study based on the ELTR registry.

Abstract: Background & Aims Direct-acting antivirals (DAAs) have dramatically improved the outcome of patients with hepatitis C virus (HCV) infection including those with decompensated cirrhosis (DC). We analyzed the evolution of indications and results of liver transplantation (LT) in the past 10 years in Europe, focusing on the changes induced by the advent of DAAs. Methods This is a cohort study based on data from the European Liver Transplant Registry (ELTR). Data of adult LTs performed between January 2007 to June 2017 for HCV, hepatitis B virus (HBV), alcohol (EtOH) and non-alcoholic steatohepatitis (NASH) were analyzed. The period was divided into different eras: interferon (IFN/RBV; 2007-2010), protease inhibitor (PI; 2011-2013) and second generation DAA (DAA; 2014-June 2017). Results Out of a total number of 60,527 LTs, 36,382 were performed in patients with HCV, HBV, EtOH and NASH. The percentage of LTs due to HCV-related liver disease varied significantly over time (p Conclusions In Europe, the number of LTs due to HCV infection is rapidly declining for both HCV-DC and HCV-HCC indications and post-LT survival has dramatically improved over the last three years. This is the first comprehensive study of the overall impact of DAA treatment for HCV on liver transplantation in Europe. Lay summary After the advent of direct-acting antivirals in 2014, a dramatic decline was observed in the number of liver transplants performed both in patients with decompensated cirrhosis due to hepatitis C virus (HCV), minus 60%, and in those with hepatocellular carcinoma associated with HCV, minus 41%. Furthermore, this is the first large-scale study demonstrating that the survival of liver transplant recipients with HCV-related liver disease has dramatically improved over the last three years and is now comparable to the survival of recipients with hepatitis B virus infection. The reduction in HCV-related indications for LT means that there is a greater availability of livers, at least 600 every year, which can be allocated to patients with indications other than HCV.

Age and liver transplantation

Abstract: The average age of liver transplant donors and recipients has increased over the years. Independent of the cause of liver disease, older candidates have more comorbidities, higher waitlist mortality and higher post-transplant mortality than younger patients. However, transplant benefit may be similar in older and younger recipients, provided older recipients are carefully selected. The cohort of elderly patients transplanted decades ago is also increasingly raising issues concerning long-term exposure to immunosuppression and aging of the transplanted liver. Excellent results can be achieved with elderly donors and there is virtually no upper age limit for donors after brain death liver transplantation. The issue is how to optimise selection, procurement and matching to ensure good results with elderly donors. The impact of old donor age is more pronounced in younger recipients and patients with a high model for end-stage liver disease score. Age matching between the donor and the recipient should be incorporated into allocation policies with a multistep approach. However, age matching may vary depending on the objectives of different allocation policies. In addition, age matching must be revisited in the era of direct-acting antivirals. More restrictive limits have been adopted in donation after circulatory death. Perfusion machines which are currently under investigation may help expand these limits. In living donor liver transplantation, donor age limit is essentially guided by morbidity related to procurement. In this review we summarise changing trends in recipient and donor age. We discuss the implications of older age donors and recipients. We also consider different options for age matching in liver transplantation that could improve outcomes.

Achieving sustained virologic response in hepatitis C: a systematic review of the clinical, economic and quality of life benefits

Abstract: The goal of chronic hepatitis C treatment is to remove the virus to avoid progression of HCV-related disease. Sustained virologic response (SVR) is the most widely used efficacy endpoint in clinical studies of hepatitis C, and represents the eradication of HCV from the body. The aim of the current review was to examine the long-term clinical, economic and quality of life benefits associated with achieving SVR. A systematic literature review was performed using the PubMed, EMBASE and Cochrane library databases to identify articles examining the clinical, economic and quality of life benefits associated with SVR, published in English language from 2002–2013. For inclusion studies were required to enroll ≥100 patients and to report clinical endpoints including hepatocellular carcinoma, overall- or liver-related mortality, or progression of disease/complications (e.g. portal hypertension, esophageal varices). Review of economic studies on cost/cost-effectiveness of achieving SVR were focused on studies assessing boceprevir/telaprevir plus pegIFN and ribavirin as this represents the current standard of care in several jurisdictions worldwide. Quality of life evidence was required to use validated quality of life instruments and provide a quantitative analysis of the impact of SVR versus no treatment or treatment failure. SVR is durable with late relapse rates over 4–5 year periods being in the range of 1–2%. Patients who achieve SVR frequently demonstrate some regression of fibrosis/cirrhosis and have a substantially reduced risk for hepatocellular carcinoma (relative risk [RR] 0.1–0.25), liver-related mortality (RR 0.03–0.2) and overall mortality (RR 0.1–0.3) in comparison with no treatment or treatment failure. In the 5 years post-treatment, medical costs for patients achieving SVR are 13-fold lower than patients not achieving SVR. Patients who achieve SVR also have health state utility values that are 0.05 to 0.31 higher than non-responders to treatment. SVR represents the fundamental goal of antiviral treatment for patients infected with chronic HCV, so as to reduce risk of liver disease progression. Achievement of SVR has implications beyond those of clearing viral infection; it is associated with improved long-term clinical outcomes, economic benefits and improved health-related quality of life.