Trabajo de coordinación para la implantación del Máster en Optometría Avanzada y Salud Visual

Durante el curso 2013-2014 la Universidad de Alicante ha propuesto la implantación del Master en Optometría Avanzada y Salud Visual, dicha solicitud está siendo actualmente evaluada por la ANECA. Con el fin de coordinar la docencia de este Máster y dentro del Proyecto de Redes de Investigación en Docencia Universitaria 2013-2014, se ha creado una red formada por todos los profesores que han participado en la elaboración del plan de estudios. En esta red esta red se pretende la coordinación entre las distintas asignaturas para elaborar las guías docentes a partir de los datos de las fichas enviadas a la ANECA. Por otra parte también se ha modificado la memoria atendiendo a las alegaciones realizadas por la ANECA. Y se han desarrollado los contenidos, la metodología de las distintas actividades propuestas con el fin de asegurar la consecución de las competencias previstas.

Microglia activation in a model of retinal degeneration and TUDCA neuroprotective effects

Background: Retinitis pigmentosa is a heterogeneous group of inherited neurodegenerative retinal disorders characterized by a progressive peripheral vision loss and night vision difficulties, subsequently leading to central vision impairment. Chronic microglia activation is associated with various neurodegenerative diseases including retinitis pigmentosa. The objective of this study was to quantify microglia activation in the retina of P23H rats, an animal model of retinitis pigmentosa, and to evaluate the therapeutic effects of TUDCA (tauroursodeoxycholic acid), which has been described as a neuroprotective compound. Methods: For this study, homozygous P23H line 3 and Sprague-Dawley (SD) rats were injected weekly with TUDCA (500 mg/kg, ip) or vehicle (saline) from 20 days to 4 months old. Vertical retinal sections and whole-mount retinas were immunostained for specific markers of microglial cells (anti-CD11b, anti-Iba1 and anti-MHC-II). Microglial cell morphology was analyzed and the number of retinal microglial was quantified. Results: Microglial cells in the SD rat retinas were arranged in regular mosaics homogenously distributed within the plexiform and ganglion cell layers. In the P23H rat retina, microglial cells increased in number in all layers compared with control SD rat retinas, preserving the regular mosaic distribution. In addition, a large number of amoeboid CD11b-positive cells were observed in the P23H rat retina, even in the subretinal space. Retinas of TUDCA-treated P23H animals exhibited lower microglial cell number in all layers and absence of microglial cells in the subretinal space. Conclusions: These results report novel TUDCA anti-inflammatory actions, with potential therapeutic implications for neurodegenerative diseases, including retinitis pigmentosa.

Todo lo que siempre quiso saber sobre la evaluación, pero no se atrevió a preguntar: a propósito de una encuesta

La evaluación es un proceso sistemático, continuo e integral destinado a determinar hasta qué punto han sido alcanzados los objetivos educativos. En ella se aúnan dos actividades fundamentales: medir y emitir juicios de valor a partir, de los datos. Sin embargo, a pesar de la claridad de estos conceptos la forma de evaluar a los alumnos todavía sigue plagada de importantes contradicciones entre los profesores, lo que manifiesta unas conductas didácticas alejadas de lo que debiera ser una pedagogía basada en la evidencia. El objetivo de este trabajo es evidenciar las citadas discrepancias, entre los agentes del proceso de enseñanza aprendizaje (alumnos y profesores), a la hora de elaborar, realizar y calificar las pruebas de evaluación (“exámenes”) de los alumnos de varias disciplinas relacionadas con la Biomedicina. La metodología empleada ha consistido en aplicar a los estudiantes un sencillo cuestionario con preguntas de elección múltiple. A partir de los resultados, se pretende reflexionar sobre conjunto de criterios sólidos que permitan realizar las evaluaciones de los alumnos con mayor validez, fiabilidad, objetividad y pertinencia, como recomienda la OMS en su Guía Pedagógica para el Personal de Salud.

Development and psychometric testing of the clinical learning environment, supervision and nurse teacher evaluation scale (CLES+T): The Spanish version

Background: The Clinical Learning Environment, Supervision and Nurse Teacher scale is a reliable and valid instrument to evaluate the quality of the clinical learning process in international nursing education contexts. Objectives: This paper reports the development and psychometric testing of the Spanish version of the Clinical Learning Environment, Supervision and Nurse Teacher scale. Design: Cross-sectional validation study of the scale. Setting: 10 public and private hospitals in the Alicante area, and the Faculty of Health Sciences (University of Alicante, Spain). Participants: 370 student nurses on clinical placement (January 2011–March 2012). Methods: The Clinical Learning Environment, Supervision and Nurse Teacher scale was translated using the modified direct translation method. Statistical analyses were performed using PASW Statistics 18 and AMOS 18.0.0 software. A multivariate analysis was conducted in order to assess construct validity. Cronbach’s alpha coefficient was used to evaluate instrument reliability. Results: An exploratory factorial analysis identified the five dimensions from the original version, and explained 66.4% of the variance. Confirmatory factor analysis supported the factor structure of the Spanish version of the instrument. Cronbach’s alpha coefficient for the scale was .95, ranging from .80 to .97 for the subscales. Conclusion: This version of the Clinical Learning Environment, Supervision and Nurse Teacher scale instrument showed acceptable psychometric properties for use as an assessment scale in Spanish-speaking countries.

Análisis de diversos métodos de evaluación implantados en distintas asignaturas de los títulos de grado

En el marco del EEES el sistema de evaluación debe valorar las competencias adquiridas por el estudiante en una determinada materia, según los conocimientos, las habilidades y las aptitudes que ha desarrollado a lo largo del proceso de enseñanza-aprendizaje. Además de las pruebas escritas diseñadas para evaluar los conocimientos y las capacidades de razonamiento, las distintas actividades de las nuevas asignaturas, como seminarios, prácticas de ordenador y de laboratorio o tutorías, se deben valorar con distintos modelos evaluadores, que dependerán a su vez de la metodología docente empleada. El objetivo de este estudio fue revisar los métodos de evaluación empleados en diversas asignaturas del Grado en Nutrición Humana y Dietética y del Grado en Óptica y Optometría de la Universidad de Alicante y analizar su contribución en los resultados globales de las asignaturas. Se han tenido en cuenta los diversos métodos de evaluación de las actividades así como las distintas formas de aplicar la evaluación continua y su influencia cualitativa en la calificación global.

Cellular responses following retinal injuries and therapeutic approaches for neurodegenerative diseases

Retinal neurodegenerative diseases like age-related macular degeneration, glaucoma, diabetic retinopathy and retinitis pigmentosa each have a different etiology and pathogenesis. However, at the cellular and molecular level, the response to retinal injury is similar in all of them, and results in morphological and functional impairment of retinal cells. This retinal degeneration may be triggered by gene defects, increased intraocular pressure, high levels of blood glucose, other types of stress or aging, but they all frequently induce a set of cell signals that lead to well-established and similar morphological and functional changes, including controlled cell death and retinal remodeling. Interestingly, an inflammatory response, oxidative stress and activation of apoptotic pathways are common features in all these diseases. Furthermore, it is important to note the relevant role of glial cells, including astrocytes, Müller cells and microglia, because their response to injury is decisive for maintaining the health of the retina or its degeneration. Several therapeutic approaches have been developed to preserve retinal function or restore eyesight in pathological conditions. In this context, neuroprotective compounds, gene therapy, cell transplantation or artificial devices should be applied at the appropriate stage of retinal degeneration to obtain successful results. This review provides an overview of the common and distinctive features of retinal neurodegenerative diseases, including the molecular, anatomical and functional changes caused by the cellular response to damage, in order to establish appropriate treatments for these pathologies.

Phosphorylated α-synuclein-immunoreactive retinal neuronal elements in Parkinson's disease subjects

Visual symptoms are relatively common in Parkinson's disease (PD) and optical coherence tomography has indicated possible retinal thinning. Accumulation of aggregated α-synuclein is thought to be a central pathogenic event in the PD brain but there have not as yet been reports of retinal synucleinopathy. Retinal wholemounts were prepared from subjects with a primary clinicopathological diagnosis of PD (N = 9), dementia with Lewy bodies (DLB; N = 3), Alzheimer's disease (N = 3), progressive supranuclear palsy (N = 2) as well as elderly normal control subjects (N = 4). These were immunohistochemically stained with an antibody against α-synuclein phosphorylated at serine 129, which is a specific molecular marker of synucleinopathy. Phosphorylated α-synuclein-immunoreactive (p-syn IR) nerve fibers were present in 7/9 PD subjects and in 1/3 DLB subjects; these were sparsely distributed and superficially located near or at the inner retinal surface. The fibers were either long and straight or branching, often with multiple en-passant varicosities along their length. The straight fibers most often had an orientation that was radial with respect to the optic disk. Together, these features are suggestive of either retinopetal/centrifugal fibers or of ganglion cell axons. In one PD subject there were sparse p-syn IR neuronal cell bodies with dendritic morphology suggestive of G19 retinal ganglion cells or intrinsically photosensitive ganglion cells. There were no stained nerve fibers or other specific staining in any of the non-PD or non-DLB subjects. It is possible that at least some of the observed visual function impairments in PD subjects might be due to α-synucleinopathy.

Expression and cellular localization of the voltage-gated calcium channel α2δ3 in the rodent retina

High-voltage-activated calcium channels are hetero-oligomeric protein complexes that mediate multiple cellular processes, including the influx of extracellular Ca2+, neurotransmitter release, gene transcription, and synaptic plasticity. These channels consist of a primary α1 pore-forming subunit, which is associated with an extracellular α2δ subunit and an intracellular β auxiliary subunit, which alter the gating properties and trafficking of the calcium channel. The cellular localization of the α2δ3 subunit in the mouse and rat retina is unknown. In this study using RT-PCR, a single band at ∼305 bp corresponding to the predicted size of the α2δ3 subunit fragment was found in mouse and rat retina and brain homogenates. Western blotting of rodent retina and brain homogenates showed a single 123-kDa band. Immunohistochemistry with an affinity-purified antibody to the α2δ3 subunit revealed immunoreactive cell bodies in the ganglion cell layer and inner nuclear layer and immunoreactive processes in the inner plexiform layer and the outer plexiform layer. α2δ3 immunoreactivity was localized to multiple cell types, including ganglion, amacrine, and bipolar cells and photoreceptors, but not horizontal cells. The expression of the α2δ3 calcium channel subunit to multiple cell types suggests that this subunit participates widely in Ca-channel-mediated signaling in the retina.

Whole-exome sequencing reveals ZNF408 as a new gene associated with autosomal recessive retinitis pigmentosa with vitreal alterations

Retinitis pigmentosa (RP) is a group of progressive inherited retinal dystrophies that cause visual impairment as a result of photoreceptor cell death. RP is heterogeneous, both clinically and genetically making difficult to establish precise genotype–phenotype correlations. In a Spanish family with autosomal recessive RP (arRP), homozygosity mapping and whole-exome sequencing led to the identification of a homozygous mutation (c.358_359delGT; p.Ala122Leufs*2) in the ZNF408 gene. A screening performed in 217 additional unrelated families revealed another homozygous mutation (c.1621C>T; p.Arg541Cys) in an isolated RP case. ZNF408 encodes a transcription factor that harbors 10 predicted C2H2-type fingers thought to be implicated in DNA binding. To elucidate the ZNF408 role in the retina and the pathogenesis of these mutations we have performed different functional studies. By immunohistochemical analysis in healthy human retina, we identified that ZNF408 is expressed in both cone and rod photoreceptors, in a specific type of amacrine and ganglion cells, and in retinal blood vessels. ZNF408 revealed a cytoplasmic localization and a nuclear distribution in areas corresponding with the euchromatin fraction. Immunolocalization studies showed a partial mislocalization of the p.Arg541Cys mutant protein retaining part of the WT protein in the cytoplasm. Our study demonstrates that ZNF408, previously associated with Familial Exudative Vitreoretinopathy (FEVR), is a new gene causing arRP with vitreous condensations supporting the evidence that this protein plays additional functions into the human retina.

First molar size and wear within and among modern hunter-gatherers and agricultural populations

Apart from reflecting modern human dental variation, differences in dental size among populations provide a means for studying continuous evolutionary processes and their mechanisms. Dental wear, on the other hand, has been widely used to infer dietary adaptations and variability among or within diverse ancient human populations. Few such studies have focused on modern foragers and farmers, however, and diverse methods have been used. This research aimed to apply a single, standardized, and systematic quantitative procedure to measure dental size and dentin exposure in order to analyze differences among several hunter-gatherer and agricultural populations from various environments and geographic origins. In particular, we focused on sexual dimorphism and intergroup differences in the upper and lower first molars. Results indicated no sexual dimorphism in molar size and wear within the studied populations. Despite the great ethnographic variation in subsistence strategies among these populations, our findings suggest that differences in sexual division of labor do not affect dietary wear patterns.

Reflexiones en torno a la evaluación de las actividades del proceso de enseñanza-aprendizaje

La evaluación es un proceso sistemático, continuo e integral destinado a determinar hasta qué punto han sido alcanzados los objetivos educativos. En ella se aúnan dos actividades fundamentales: medir y emitir juicios de valor a partir, de los datos. Sin embargo, a pesar de la claridad de estos conceptos la forma de evaluar a los alumnos todavía sigue plagada de importantes contradicciones entre los profesores, lo que manifiesta unas conductas didácticas alejadas de lo que debiera ser una pedagogía basada en la evidencia. El objetivo de este proyecto es evidenciar las citadas discrepancias, entre los agentes del proceso de enseñanza aprendizaje (alumnos y profesores), a la hora de elaborar, realizar y calificar las pruebas de evaluación (“exámenes”) de los alumnos de varias disciplinas relacionadas con la Biomedicina. La metodología empleada ha consistido en aplicar a los estudiantes un sencillo cuestionario con preguntas de elección múltiple. A partir de los resultados, se pretende reflexionar sobre conjunto de criterios sólidos que permitan realizar las evaluaciones de los alumnos con mayor validez, fiabilidad, objetividad y pertinencia, como recomienda la OMS en su Guía Pedagógica para el Personal de Salud.

Natural Compounds from Saffron and Bear Bile Prevent Vision Loss and Retinal Degeneration

All retinal disorders, regardless of their aetiology, involve the activation of oxidative stress and apoptosis pathways. The administration of neuroprotective factors is crucial in all phases of the pathology, even when vision has been completely lost. The retina is one of the most susceptible tissues to reactive oxygen species damage. On the other hand, proper development and functioning of the retina requires a precise balance between the processes of proliferation, differentiation and programmed cell death. The life-or-death decision seems to be the result of a complex balance between pro- and anti-apoptotic signals. It has been recently shown the efficacy of natural products to slow retinal degenerative process through different pathways. In this review, we assess the neuroprotective effect of two compounds used in the ancient pharmacopoeia. On one hand, it has been demonstrated that administration of the saffron constituent safranal to P23H rats, an animal model of retinitis pigmentosa, preserves photoreceptor morphology and number, the capillary network and the visual response. On the other hand, it has been shown that systemic administration of tauroursodeoxycholic acid (TUDCA), the major component of bear bile, to P23H rats preserves cone and rod structure and function, together with their contact with postsynaptic neurons. The neuroprotective effects of safranal and TUDCA make these compounds potentially useful for therapeutic applications in retinal degenerative diseases.

Human iPSC derived disease model of MERTK-associated retinitis pigmentosa

Retinitis pigmentosa (RP) represents a genetically heterogeneous group of retinal dystrophies affecting mainly the rod photoreceptors and in some instances also the retinal pigment epithelium (RPE) cells of the retina. Clinical symptoms and disease progression leading to moderate to severe loss of vision are well established and despite significant progress in the identification of causative genes, the disease pathology remains unclear. Lack of this understanding has so far hindered development of effective therapies. Here we report successful generation of human induced pluripotent stem cells (iPSC) from skin fibroblasts of a patient harboring a novel Ser331Cysfs*5 mutation in the MERTK gene. The patient was diagnosed with an early onset and severe form of autosomal recessive RP (arRP). Upon differentiation of these iPSC towards RPE, patient-specific RPE cells exhibited defective phagocytosis, a characteristic phenotype of MERTK deficiency observed in human patients and animal models. Thus we have created a faithful cellular model of arRP incorporating the human genetic background which will allow us to investigate in detail the disease mechanism, explore screening of a variety of therapeutic compounds/reagents and design either combined cell and gene- based therapies or independent approaches.

Aprendizaje de imágenes histológicas utilizando un microscopio virtual: metodología y opinión de los alumnos

El concepto de tejido es un constructo teorético muy útil para aprender a conocer las estructuras microscópicas del organismo y para diagnosticar, de forma objetiva, la mayoría de las lesiones, a través de imágenes histológicas (IH). Tradicionalmente, aprender a interpretar IH se basa en su observación repetitiva y monótona. Esto y la consideración de la Histología como una disciplina meramente descriptiva, ha determinado su escasa relevancia y su alto nivel de olvido para los alumnos, como ha sido puesto de relieve en varias publicaciones. Los recursos digitales han facilitado, de forma sustancial, el aprendizaje de la Histología, aunque todavía sigue basándose en la observación iterativa y monótona de IH. Para facilitar y mejorar dicho aprendizaje hemos creando y publicado una clasificación y sistematización de las IH. En este trabajo presentamos la combinación de la sistematización de las IH con el uso de un microscopio virtual accesible a todos los alumnos en cualquier lugar y momento (tablets, smartphones, ordenadores de mesa, portátiles, etc.). La evaluación de esta metodología, mediante una encuesta, pone de manifiesto su alto grado de aceptación por los alumnos y sus enormes posibilidades para un aprendizaje, a la vez, autónomo y colaborativo.

Rendimiento académico del ABP en Anatomía

Desde que en la Universidad de Alicante se implantaron los nuevos planes de estudios EEES en el curso 2010-11, hasta la actualidad, se ha estado aplicando la metodología docente colaborativa de aprendizaje basado en problemas (ABP) en asignaturas del área de Anatomía Humana y Embriología impartidas en los primeros cursos de las titulaciones de Grado en “Enfermería”, “Nutrición Humana y Dietética”, “Óptica y Optometría” y “Ciencias de la Actividad Física y del Deporte”. El objetivo de este estudio es comparar los resultados de aprendizaje a través del rendimiento académico obtenido en la evaluación continua según diferentes metodologías docentes. En general, las calificaciones obtenidas en la evaluación de la exposición oral en grupo del trabajo ABP fueron mucho mejores en todas las asignaturas a lo largo de los últimos 5 años. Los resultados de las pruebas objetivas de respuesta múltiple usadas para evaluar los logros de aprendizaje mediante el uso de clases magistrales de teoría y prácticas de laboratorio fueron algo inferiores. Se plantea la posibilidad de incrementar el número de actividades de ABP y asignar un mayor peso en la ponderación de los criterios de evaluación de la asignatura.