El diseño representado a través de la artesanía. Emprendedores de la etnia Mapuche. Región de la Araucanía, Chile

The following article presents an extract of the research carried out to qualify for the degree of Doctor of Design at the University of Palermo, in Buenos Aires. Argentina. Referred to the development of Mapuche entrepreneurs craftsmanship in La Araucanía region, Chile. This article studies the relationship between designs with graphic motives in the elaboration of handmade products. Materials such as leather, silver, wool, ceramic clay and wood are some of the study´s objects that are presented in proposals of entrepreneurs who design graphic motifs.En el siguiente artículo se presenta una síntesis de la investigación realizada en el marco del Doctorado en Diseño de la Universidad de Palermo, Buenos Aires, Argentina. El estudio es referido al desarrollo de la artesanía en emprendedores de etnia Mapuche en la región de La Araucanía, Chile. El abordaje se orienta al estudio de la relación que tiene el trabajo en diseño con motivos gráficos en materiales y formatos que permite la elaboración de productos artesanales. Materiales como el cuero, la plata, la lana, la cerámica greda y la madera son algunos de los objetos de estudio que se presentan en las propuestas de los emprendedores que diseñan motivos gráficos en ellas.O artigo a seguir apresenta um extrato da pesquisa realizada para se qualificar para o grau de Doutor em Design na Universidade de Palermo, em Buenos Aires. Argentina Referiu-se ao desenvolvimento de artesanato em empresários mapuche na região de La Araucanía. Chile Uma abordagem sobre a relação direta que tem o trabalho em design com motivos gráficos nos formatos que permitem a elaboração de produtos artesanais. Materiais como couro, prata, lã, argila cerâmica e madeira são alguns dos objetos de estudo que são apresentados em propostas de empreendedores que desenham motivos gráficos neles

La enseñanza del diseño en modalidad virtual

En la actualidad la enseñanza online ha sido una actividad que la mayoría de los docentes ha tenido que ejercitar y sobre todo en contextos de pandemia mundial.&nbsp

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Time to Switch to Second-line Antiretroviral Therapy in Children With Human Immunodeficiency Virus in Europe and Thailand.

Background: Data on durability of first-line antiretroviral therapy (ART) in children with human immunodeficiency virus (HIV) are limited. We assessed time to switch to second-line therapy in 16 European countries and Thailand. Methods: Children aged <18 years initiating combination ART (≥2 nucleoside reverse transcriptase inhibitors [NRTIs] plus nonnucleoside reverse transcriptase inhibitor [NNRTI] or boosted protease inhibitor [PI]) were included. Switch to second-line was defined as (i) change across drug class (PI to NNRTI or vice versa) or within PI class plus change of ≥1 NRTI; (ii) change from single to dual PI; or (iii) addition of a new drug class. Cumulative incidence of switch was calculated with death and loss to follow-up as competing risks. Results: Of 3668 children included, median age at ART initiation was 6.1 (interquartile range (IQR), 1.7-10.5) years. Initial regimens were 32% PI based, 34% nevirapine (NVP) based, and 33% efavirenz based. Median duration of follow-up was 5.4 (IQR, 2.9-8.3) years. Cumulative incidence of switch at 5 years was 21% (95% confidence interval, 20%-23%), with significant regional variations. Median time to switch was 30 (IQR, 16-58) months; two-thirds of switches were related to treatment failure. In multivariable analysis, older age, severe immunosuppression and higher viral load (VL) at ART start, and NVP-based initial regimens were associated with increased risk of switch. Conclusions: One in 5 children switched to a second-line regimen by 5 years of ART, with two-thirds failure related. Advanced HIV, older age, and NVP-based regimens were associated with increased risk of switch

Uso del color y patrones geométricos en los diseños Mapuche contemporáneos: Adaptación semiótica en tres casos de estudio comparados

The article presents three cases of women entrepreneurs of the Mapuche culture in the Araucanía region, specifically in their creations, designs with graphic motif are observed in different materials. The cases were selected on the basis of a doctoral thesis in design from the University of Palermo, in which the female presence with an age range between 20 and 30 years stands out. It is considered important, first of all, to highlight the importance of color in creation, according to the Mapuche symbology and the geometry present in the patterns of repetition in designs and the use of different materials by women. Methodologically, specific cases of analysis are presented, approaching their creations based on Mapuche materiality, design, inspiration and heritage, to culminate with a graphic presentation of geometric patterns of the history of the native people in confrontation with the new trends of young entrepreneurs. Finally, a selection of the designs of the young entrepreneurs is exhibited, where the inheritance of the culturalfamily task is evidenced together with new presentations on the designs, ethics and exploration of new materials.El artículo presenta tres casos de emprendedoras de cultura Mapuche en la región de la Araucanía, específicamente en sus creaciones se observan diseños con motivo gráfico en distintos materiales. Los casos fueron seleccionados sobre la base de una tesis doctoral en diseño de la Universidad de Palermo, en la cual destaca la presencia femenina con rango etario entre los 20 y 30 años. Se considera importante, en primer lugar, relevar la importancia del color en la creación, de acuerdo a la simbología mapuche y la geometría presente en los patrones de repetición en los diseños y la utilización de diferentes materiales por las mujeres. Metodológicamente se presentan casos específicos de análisis, abordando sus creaciones a partir de la materialidad, diseño, inspiración y herencia Mapuche, para culminar con una presentación gráfica de patrones geométricos de la historia del pueblo originario en confrontación con las nuevas tendencias de las jóvenes emprendedoras. Por último, se exhibe una selección de los diseños de las jóvenes emprendedoras, en donde se evidencia la herencia del quehacer cultural-familiar en conjunto con nuevas presentaciones en los diseños, en la ética y en la exploración de nuevos materiales.O artigo apresenta três casos de mulheres empresárias da cultura mapuche na região de Araucanía, especificamente em suas criações, desenhos com motivos gráficos são observados em diferentes materiais. Os casos foram selecionados com base em uma tese de doutorado em design da Universidade de Palermo, na qual se destaca a presença feminina com idade entre 20 e 30 anos. Considera-se importante, antes de tudo, destacar a importância da cor na criação, de acordo com a simbologia mapuche e a geometria presente nos padrões de repetição nos desenhos e no uso de diferentes materiais pelas mulheres. Metodologicamente, são apresentados casos específicos de análise, abordando suas criações com base na materialidade mapuche, design, inspiração e patrimônio, para culminar com uma apresentação gráfica de padrões geométricos da história do povo nativo em confronto com as novas tendências dos jovens empreendedores. Por fim, é exibida uma seleção dos desenhos dos jovens empreendedores, onde a herança da tarefa cultural-familiar é evidenciada juntamente com novas apresentações sobre os desenhos, a ética e a exploração de novos materiais

Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study

International audienceIn human immunodeficiency virus (HIV)-positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART

Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study

BACKGROUND: In human immunodeficiency virus (HIV)-positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART. METHODS: Sixteen cohorts from the European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) contributed data. Children &lt;18 years at ART initiation, with sustained viral suppression (VS) (≤400 copies/mL) for ≥1 year were included. The prevalence of PIR (defined as World Health Organization advanced/severe immunosuppression for age) at 1 year of VS was described. Factors associated with PIR were assessed using logistic regression. Rates of acquired immunodeficiency syndrome (AIDS) or death on suppressive ART were calculated by PIR status. RESULTS: Of 2318 children included, median age was 6.4 years and 68% had advanced/severe immunosuppression at ART initiation. At 1 year of VS, 12% had PIR. In multivariable analysis, PIR was associated with older age and worse immunological stage at ART start, hepatitis B coinfection, and residing in Thailand (all P ≤ .03). Rates of AIDS/death (95% confidence interval) per 100 000 person-years were 1052 (547, 2022) among PIR versus 261 (166, 409) among immune responders; rate ratio of 4.04 (1.83, 8.92; P &lt; .001). CONCLUSIONS: One in eight children in our cohort experienced PIR despite sustained VS. While the overall rate of AIDS/death was low, children with PIR had a 4-fold increase in risk of event as compared with immune responders

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk