Las relaciones centro/periferia en el Valle del Guadalquivir del III milenio ANE: La circulación de hojas de caliza oolítica silicificada

Este estudio presenta una interpretación, en términos de relaciones centro-periferia, por medio de un análisis petrológico, morfométrico, espacial y contextual de las hojas de caliza oolítica silicificada documentadas en yacimientos arqueológicos fechados en el III milenio ANE, en el sur de la Península Ibérica. Este análisis documenta la existencia de redes de circulación supra-regionales de productos acabados, altamente estandarizados, sobre una distancia de más de 500 km, y un área de más de 222.000 km2. Adicionalmente, convierte a las hojas de caliza oolítica silicificada en un indicador arqueológico de las rutas, tipos y contenidos de las relaciones intersociales de y en torno al marco de jerarquización entre asentamientos del Valle del Guadalquivir desde 3000 hasta 2500 ANE, señalando la emergencia y colapso de un sistema político.This study offers an alternative explanation, in terms of core/periphery relationships, by means of a petrologic, morphometric, spatial and contextual analysis of the silicified oolitic limestone blades found in archaeological sites dated back to the third millennium ANE in southern Iberia. This suggests the existence of a supra-regional circulation of highly standardized, finished products, which spread over a distance of more than 500 km, and an area of over 222.000 km2. In this sense, the blades have become the first archaeological indicator of the paths, types and contents of the relationships developed within and around the inter-settlement hierarchical framework of the Guadalquivir Valley from 3000 to 2500 BC, accounting for the emergence and collapse of a political system

Endometrial carcinoma, grossing and processing issues: recommendations of the International Society of Gynecologic Pathologists.

Endometrial cancer is the most common gynecologic neoplasm in developed countries; however, updated universal guidelines are currently not available to handle specimens obtained during the surgical treatment of patients affected by this disease. This article presents recommendations on how to gross and submit sections for microscopic examination of hysterectomy specimens and other tissues removed during the surgical management of endometrial cancer such as salpingo-oophorectomy, omentectomy, and lymph node dissection-including sentinel lymph nodes. In addition, the intraoperative assessment of some of these specimens is addressed. These recommendations are based on a review of the literature, grossing manuals from various institutions, and a collaborative effort by a subgroup of the Endometrial Cancer Task Force of the International Society of Gynecological Pathologists. The aim of these recommendations is to standardize the processing of endometrial cancer specimens which is vital for adequate pathological reporting and will ultimately improve our understanding of this disease

Pathologic Prognostic Factors in Endometrial Carcinoma (Other Than Tumor Type and Grade)

Although endometrial carcinoma (EC) is generally considered to have a good prognosis, over 20% of women with EC die of their disease, with a projected increase in both incidence and mortality over the next few decades. The aim of accurate prognostication is to ensure that patients receive optimal treatment and are neither overtreated nor undertreated, thereby improving patient outcomes overall. Patients with EC can be categorized into prognostic risk groups based on clinicopathologic findings. Other than tumor type and grade, groupings and recommended management algorithms may take into account age, body mass index, stage, and presence of lymphovascular space invasion. The molecular classification of EC that has emerged from the Cancer Genome Atlas (TCGA) study provides additional, potentially superior, prognostic information to traditional histologic typing and grading. This classifier does not, however, replace clinicopathologic risk assessment based on parameters other than histotype and grade. It is envisaged that molecular and clinicopathologic prognostic grouping systems will work better together than either alone. Thus, while tumor typing and grading may be superseded by a classification based on underlying genomic abnormalities, accurate assessment of other pathologic parameters will continue to be key to patient management. These include those factors related to staging, such as depth of myometrial invasion, cervical, vaginal, serosal surface, adnexal and parametrial invasion, and those independent of stage such as lymphovascular space invasion. Other prognostic parameters will also be discussed. These recommendations were developed from the International Society of Gynecological Pathologists Endometrial Carcinoma project

Screening for neurocognitive impairment, depression, and anxiety in HIV-infected patients in Western Europe and Canada

CRANIum, a cross-sectional epidemiology study in Western Europe and Canada, was conducted to describe and compare the prevalence of a positive screen for neurocognitive impairment (NCI), depressive symptoms, and anxiety in an HIV-positive population either receiving combination antiretroviral therapy (cART) or who were naive to antiretroviral therapy (ART). HIV-positive patients ≥18 years of age attending a routine medical follow-up visit and able to complete the designated screening tools were eligible for study inclusion. The Brief Neurocognitive Screen was used to assess NCI; depressive and anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale. The evaluable patient population (N = 2863) included 1766 men (61.7%) and 1096 (38.3%) women. A total of 1969 patients were cART-experienced (68.8%), and 894 were ART-naive (31.2%). A positive screen for NCI was found in 41.5% of patients (cART-experienced, 42.5%; ART-naive, 39.4%; p = 0.12). A positive screen for depressive symptoms was found in 15.7% of patients (cART-experienced, 16.8%; ART-naive, 13.3%; p = 0.01), whereas 33.3% of patients screened positive for anxiety (cART-experienced, 33.5%; ART-naive, 32.8%; p = 0.71). A greater percentage of women compared with men screened positive for NCI (51.78% vs. 35.1%; p < 0.0001) and depressive symptoms (17.9% vs. 14.3%; p = 0.01). These data suggest that neurocognitive and mood disorders remain highly prevalent in HIV-infected patients. Regular mental health screening in this population is warranted

Online Training and Self-assessment in the Histopathologic Classification of Endocervical Adenocarcinoma and Diagnosis of Pattern of Invasion: Evaluation of Participant Performance

Histopathologic classification of endocervical adenocarcinomas (EAC) has recently changed, with the new system based on human papillomavirus (HPV)-related morphologic features being incorporated into the 5th edition of the WHO Blue Book (Classification of Tumours of the Female Genital Tract). There has also been the introduction of a pattern-based classification system to assess invasion in HPV-associated (HPVA) endocervical adenocarcinomas that stratifies tumors into 3 groups with different prognoses. To facilitate the introduction of these changes into routine clinical practice, websites with training sets and test sets of scanned whole slide images were designed to improve diagnostic performance in histotype classification of endocervical adenocarcinoma based on the International Endocervical Adenocarcinoma Criteria and Classification (IECC) and assessment of Silva pattern of invasion in HPVA endocervical adenocarcinomas. We report on the diagnostic results of those who have participated thus far in these educational websites. Our goal was to identify areas where diagnostic performance was suboptimal and future educational efforts could be directed. There was very good ability to distinguish HPVA from HPV-independent adenocarcinomas within the WHO/IECC classification, with some challenges in the diagnosis of HPV-independent subtypes, especially mesonephric carcinoma. Diagnosis of HPVA subtypes was not consistent. For the Silva classification, the main challenge was related to distinction between pattern A and pattern B, with a tendency for participants to overdiagnose pattern B invasion. These observations can serve as the basis for more targeted efforts to improve diagnostic performance

Update for the practicing pathologist: The International Consultation On Urologic Disease-European association of urology consultation on bladder cancer

The International Consultations on Urological Diseases are international consensus meetings, supported by the World Health Organization and the Union Internationale Contre le Cancer, which have occurred since 1981. Each consultation has the goal of convening experts to review data and provide evidence-based recommendations to improve practice. In 2012, the selected subject was bladder cancer, a disease which remains a major public health problem with little improvement in many years. The proceedings of the 2nd International Consultation on Bladder Cancer, which included a 'Pathology of Bladder Cancer Work Group,' have recently been published; herein, we provide a summary of developments and consensus relevant to the practicing pathologist. Although the published proceedings have tackled a comprehensive set of issues regarding the pathology of bladder cancer, this update summarizes the recommendations regarding selected issues for the practicing pathologist. These include guidelines for classification and grading of urothelial neoplasia, with particular emphasis on the approach to inverted lesions, the handling of incipient papillary lesions frequently seen during surveillance of bladder cancer patients, descriptions of newer variants, and terminology for urine cytology reporting

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

La evaluación en acciones educativas a distancia: el caso de la Universidad Metropolitana

Assessment has been subject of study, discussion and controversy for decades. Its meaning, its design, the most appropriate methods in each case, the validity of its results and its consequences have been subject to reflection and research in order to identify the best practices in this matter. Given the above as a true fact in the field of traditional education, which is characterized by the assistance to classrooms, it has also become a reality �and perhaps more urgent� for those modalities in which the teacher and the student perform from distance, with flexible spatial and temporal patterns. Under this premise is undertaken a study aimed to describe assessment in distance education activities being carried out at the Universidad Metropolitana, in Caracas, Venezuela. Methodology attends the interpretative paradigm tenets, with a descriptive design and a mixed approach. Based on the realization of the event under study and on the specific context, this research relies on a case study. Results demonstrated the accomplishment of the research objectives and provided useful evidence for the understanding of assessment in this particular context. Result analysis and the establishment of relationships among them led to conclusions that not only served the purpose of the study, but threw light on future courses of action aimed at improving assessment in distance education, as well as other important tasks at Universidad Metropolitana in order to fulfill its mission.La evaluación de los aprendizajes ha sido tema de estudio, discusión y controversia durante décadas. Su significado, su diseño, los métodos más adecuados en cada caso, la validez de sus resultados y sus consecuencias han estado sujetos a reflexión e investigación, con miras a determinar las mejores prácticas. Siendo esto cierto en el ámbito de la educación tradicional, caracterizada por la asistencia a las aulas, se ha convertido también en una realidad �y quizás más urgente� para las modalidades educativas en las que el docente y el estudiante operan a distancia, en marcos espaciotemporales flexibles. Bajo esta premisa se emprende un trabajo de investigación con el objetivo de describir los procesos de evaluación que se desarrollan en las acciones educativas a distancia de la Universidad Metropolitana, en Caracas, Venezuela. La metodología atiende a los postulados del paradigma interpretativo, con diseño descriptivo y con enfoque mixto. La concreción del evento en estudio y la especificidad del contexto, inscriben la investigación en la modalidad Estudio de casos. Los resultados demostraron el logro de los objetivos de la investigación y aportaron evidencia útil para la comprensión de los procesos evaluativos en este particular contexto. Su análisis y el establecimiento de relaciones entre ellos condujeron a conclusiones que cumplieron con el propósito planteado y arrojaron luces sobre posibles acciones dirigidas a mejorar tanto la evaluación de los aprendizajes en las acciones educativas a distancia como otros elementos importantes en el quehacer de la Universidad Metropolitana para el cumplimiento de su misió