Adaptarse o morir. La reinterpretación de la imagen en la postfotografía

El acto fotográfico por lo tanto, se ha modificado y toma información de la realidad que posteriormente se transformará para construir nuevas realidades –esta imagen fotográfica se finaliza con el retoque y edición consecuentes–-, y es la experiencia del autor y sus creencias las que dejaran huella en la interpretación que se realiza en cada captura. Es importante subrayar, que resulta imposible lograr que el término fotografía sea sustituido por el de postfotografía, aun cuando, también es importante que las personas estén conscientes de que la imagen que se esta produciendo en la actualidad al darle un clic a sus celulares o tabletas, no es la misma con la que se empezó el fenómeno de la fotografía, sino que es algo diferenteLas nuevas tecnologías han buscado facilitar la vida al hombre y la acelerada carrera de su evolución ha avanzado a pasos agigantados. La llegada de internet y las redes sociales como twitter, facebook, instragam y pinterest, han llegado a revolucionar las maneras de ocio y de relación social. Como soporte de intercambio de información las distancias se estrecharon y es posible la emisión instantánea de la información y el acceso, masivo y global a una cuenta personal que se presenta como ventana al mundo. Entonces después de observar la situación que vive actualmente en la sociedad actual queda una gran interrogante, lo que se busca es darle respuesta a la siguiente pregunta ¿Cómo podrías reinterpretar la imagen en la postfotografía?CONACY

Universitus: Identidad visual

Este proyecto de identidad ayudará a los diseñadores gráficos en formación a tener una referencia para el desarrollo de proyectos gráficos que estén asociados con este tipo de sectores, y en general, a todo aquel diseñador gráfico que empiece a bocetar una imagen o identidad corporativa, toda vez que como lo dije anteriormente, aplicar una metodología de diseño, es medular para obtener los mejores resultados.Universitus en su primera aparición nace como el primer simulador de escuela legislativa en el país, pretende que los universitarios y egresados con formación universitaria se vayan incluyendo en este tipo de experiencias e interacciones políticas que les permite conocer las diferentes ideologías y trabajar armoniosamente; con el objetivo de que en un corto plazo puedan ir generando propuestas de mejora social con un fundamento académico y un amplio conocimiento sociocultural. Es en este tipo de eventos en los que el diseño gráfico se convierte en una herramienta fundamental ya que mediante la imagen ayuda a fortalecer el sentido de pertenecía a ciertas instituciones, -como en este caso particular-, en la que el propósito inicial es que los jóvenes con formación universitaria se sientan identificados en el ámbito político, en el que po- cas veces participan, debido a que existe un gran nivel de desconfianza en esta área, tal vez por el gran bombardeo de información en los medios de comunicación y el poco trabajo que realizan las personas en puestos de elección popular. El diseño de identidad de Universitus presenta en un primer capítulo, una visión general de como surge la idea de un si- mulador político, en un alumno de derecho de la UAEMex, quien lo propone como una estrategia para la recepción de ideas nuevas y frescas mejor visualizadas y argumentadas; también se muestra cómo se llevo a cabo el evento. En el capítulo dos, se mencionan algunos conceptos básicos sobre el diseño y la identidad visual, haciendo un pequeño recorrido por los antecedentes del diseño, a través de una revisión de las ideas de diferentes autores, así como también se hace referencia a los elementos básicos que componen a la comunicación visual, lo que hará entender cual es el antecedente de lo que se realizará como logo y parte de la imagen hasta llegar a la creación de una identidad institucional. En el capítulo tres, se desarrolla la metodología de diseño en la que se sustenta la realización, del proyecto gráfico, apoyado en el método proyectual de Bruno Munari, considerando algunas de las etapas de este método que se adaptan al proyecto conforme a la petición del cliente para desarrollar la identidad institucional solicitada

El avance de la gentrificación en Barcelona y Madrid, 2011-2019 : análisis socioespacial a partir de un índice de gentrificación

Altres ajuts: CERCA Programme/Generalitat de Catalunya ; Programa Talent ( Universitat Autònoma de Barcelona)Las causas y los efectos de la gentrificación han recibido en los últimos años una amplia cobertura por parte de investigadores, administraciones públicas, entidades sociales y medios de comunicación, entre otros. Pese a todo, aún disponemos de poca evidencia cuantitativa que permita diseccionar la diversidad de elementos sociodemográficos que han intervenido en los procesos de gentrificación de las ciudades españolas. En el presente artículo queremos contribuir a ampliar este tipo de aproximación a través de dos ejes principales de análisis. En primer lugar, calculamos un índice de gentrificación que mide la intensidad de los procesos de transformación sociodemográfica en los barrios de Barcelona y Madrid desde 2011 hasta 2019 con base en datos homogéneos de stock (lecturas del padrón municipal) y de flujos (registros de cambios de domicilio y migraciones). En segundo lugar, comparamos los patrones espaciales del índice y exploramos las similitudes y singularidades con las que se ha manifestado la gentrificación a partir de los siguientes ejes de análisis, asociados a la vulnerabilidad social de los barrios: (i) perfil de los nuevos habitantes, (ii) expulsión y desplazamiento de la población y (iii) velocidad del cambio poblacional. Los resultados muestran la expansión de la gentrificación hacia áreas que habían permanecido ajenas a estas dinámicas, así como la existencia de rasgos distintivos en los procesos de ambas ciudades

Impact of heart failure on the clinical profile and outcomes in patients with atrial fibrillation treated with rivaroxaban. Data from the EMIR study

Background: The aim of this study was to analyze the impact of the presence of heart failure (HF) on the clinical profile and outcomes in patients with atrial fibrillation (AF) anticoagulated with rivaroxaban. Methods: Observational and non-interventional study that included AF adults recruited from 79 Spanish centers, anticoagulated with rivaroxaban ≥ 6 months before inclusion. Data were analyzed according to baseline HF status. Results: Out of 1,433 patients, 326 (22.7%) had HF at baseline. Compared to patients without HF, HF patients were older (75.3 ± 9.9 vs. 73.8 ± 9.6 years; p = 0.01), had more diabetes (36.5% vs. 24.3%; p < 0.01), coronary artery disease (28.2% vs. 12.9%; p < 0.01), renal insufficiency (31.7% vs. 22.6%; p = 0.01), higher CHA2DS2-VASc (4.5 ± 1.6 vs. 3.2 ± 1.4; p < 0.01) and HAS-BLED (1.8 ± 1.1 vs. 1.5 ± 1.0; p < 0.01). After a median follow-up of 2.5 years, among HF patients, annual rates of stroke/systemic embolism/transient ischemic attack, MACE-non-fatal myocardial infarction, revascularization and cardiovascular death-, cardiovascular death, and major bleeding were 1.2%, 3.0%, 2.0%, and 1.4%, respectively. Compared to those patients without HF, HF patients had greater annual rates of MACE (3.0% vs. 0.5%; p < 0.01) and cardiovascular death (2.0% vs. 0.2%; p < 0.01), without significant differences regarding other outcomes, including thromboembolic or bleeding events. Previous HF was an independent predictor of MACE (odds ratio 3.4; 95% confidence interval 1.6-7.3; p = 0.002) but not for thromboembolic events or major bleeding. Conclusions: Among AF patients anticoagulated with rivaroxaban, HF patients had a worse clinical profile and a higher MACE risk and cardiovascular mortality. HF was independently associated with the development of MACE, but not with thromboembolic events or major bleeding

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Diseño para el consumo cultural, la innovación y la inclusión social

Esta obra presenta diversos trabajos de investigación que tienen en común propuestas de diseño desde la cultura, la inclusión y la innovación social, desarrolladas por investigadores nacionales e internacionales adscritos a diversas universidades, así como a programas de posgrado

Spontaneous Breathing in Early Acute Respiratory Distress Syndrome: Insights From the Large Observational Study to UNderstand the Global Impact of Severe Acute Respiratory FailurE Study

OBJECTIVES: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. DESIGN: Planned secondary analysis of a prospective, observational, multicentre cohort study. SETTING: International sample of 459 ICUs from 50 countries. PATIENTS: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. INTERVENTIONS: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92-1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93-1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0-22] vs 8 [0-20]; p = 0.014) and shorter duration of ICU stay (11 [6-20] vs 12 [7-22]; p = 0.04). CONCLUSIONS: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required

Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database

Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013