Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

El carnaval en la obra El público de Lorca

The aim of this paper is to distinguish different dramatic levels inside The Public by Federico García Lorca. To do that, the edition with a foreword by Dr. Huerta Calvo (2006) will be used. Along with comments on those levels, this study will try to relate them to the transgressive sense of carnival and structural aspect of dramatic text. For this we will use authors such as Julio Huélamo Kosma (1996) for interpretation and José Luis García Barrientos (2012) for the analysis of the dramatic levels of the text, which help us to relate it to the theme proposed by the author.O objetivo deste artigo é distinguir os diferentes níveis dramáticos que compõem o público de Federico García Lorca. Para isso, será utilizada a edição aprovada pela Dra. Huerta Calvo (2006). Juntamente com os comentários sobre os níveis, tentaremos relacioná-los com o sentido carnavalesco-transgressivo. Embora neste caso os principais interesses tratem de um aspecto estrutural, vários estudos temáticos que foram realizados sobre o trabalho apoiarão. Para isso, utilizaremos autores como Julio Huélamo Kosma (1996) para interpretação e José Luis García Barrientos (2012) para a análise dos níveis dramáticos do texto, que nos ajudam a relacioná-lo com o tema proposto pelo autor.La meta del presente trabajo es distinguir los diferentes niveles dramáticos que componen El público de Federico García Lorca. Para ello se utilizará la edición prologada por el doctor Huerta Calvo (2006). A la par de los comentarios sobre los niveles dramáticos, se intentará relacionar con el sentido transgresor carnavalesco y la estructura del texto dramático. Para ello nos valdremos de autores como Julio Huélamo Kosma (1996) para la interpretación y de José Luis García Barrientos (2012) para el análisis de los niveles dramáticos del texto, que nos ayuden a relacionarla con el tema propuesto por el autor

Adecuaciones de la espera: la repetición como forma de construcción dramática

The present work is an analysis on the work Audience, by the Czech playwright Václav Havel (1936-2011), based on the dramatological method proposed by José Luis García Barrientos. We take as a basis the dramatic text, which is a linguistic text of verbal and nonverbal coding, reproductive as well as descriptive. Our objective is to know the operation of the four elements that compose the dramatic text: space, time, character and public (vision) in the whole of the work, based on the proposed method. These fundamental elements form dramatic action; what happens between some characters in a space and for a time in front of an audience. Through this analysis we can observe from each of them how they interact to build this fictional universe.O presente trabalho é uma análise do trabalho Audiencia, do dramaturgo checo Václav Havel (1936-2011), com base no método dramatológico proposto por José Luis García Barrientos. Tomamos como base o texto dramático, que é um texto lingüístico de codificação verbal e não verbal, reprodutivo e descritivo. Nosso objetivo é conhecer o funcionamento dos quatro elementos que compõem o texto dramático: espaço, tempo, caráter e público (visão) em todo o trabalho, a partir do método proposto. Esses elementos fundamentais formam a ação dramática; o que acontece entre personagens em um espaço e por um tempo na frente de uma audiência. Através desta análise podemos observar de cada uma delas como eles interagem para construir este universo fictício.El presente trabajo es un análisis sobre la obra Audiencia, del dramaturgo checo Václav Havel (1936-2011), a partir del método dramatológico propuesto por José Luis García Barrientos. Tomamos como base el texto dramático, el cual es un texto lingüístico de codificación verbal y no verbal, reproductivo a la vez que descriptivo. Nuestro objetivo es conocer el funcionamiento de los cuatro elementos que componen el texto dramático: espacio, tiempo, personaje y público (visión) en el conjunto de la obra, a partir del método propuesto. Estos elementos fundamentales forman la acción dramática; lo que ocurre entre unos personajes en un espacio y durante un tiempo frente a un público. A través de este análisis podremos observar a partir de cada uno de ellos como interaccionan para construir este universo ficcional

Sobre teatro y lo indefinible: Una perspectiva sobre la des-limitación del teatro.

The text deals with various postures that have been spilled over art, starting from a perspective of the concept of theater in contemporary times from authors and researchers such as Dubatti, García Barrientos and Barba, focusing on the concept of dramatic art, theatrical, theatricality and its particularities. It is interesting to observe how the concept has lost its borders and generates loans to the daily. This weakening of its borders has generated that we seek not a new way of naming the phenomenon, but how the elements that make it interact.El texto aborda diversas posturas que se han vertido sobre el arte. Partimos desde una perspectiva del concepto de teatro en la contemporaneidad a partir de autores e investigadores como Dubatti, García Barrientos y Barba, principalmente, enfocándonos posteriormente en el concepto arte dramático, teatral, teatralidad y sus particularidades. Interesa observar como el concepto ha perdido sus fronteras y genera prestamos hacia lo cotidiano. Este debilitamiento de sus fronteras ha generado que busquemos no una nueva forma de nombrar el fenómeno, sino observar cómo interactúan los elementos que lo conforman.O texto aborda vários cargos que foram encontrados no art. Começamos a partir de uma perspectiva do conceito de teatro contemporâneo de autores e pesquisadores como Dubatti, García Barrientos e Barba, enfocando principalmente o conceito de arte dramática, teatro, teatralidade e suas particularidades. É interessante observar como o conceito perdeu suas fronteiras e gera empréstimos para o cotidiano. Esse enfraquecimento de suas fronteiras nos levou a não buscar uma nova maneira de nomear o fenômeno, mas a observar como os elementos que o compõem interagem

Contribución al estudio de un género espectacular: el teatro de calle contemporáneo

El presente trabajo consta de cinco partes. En la primera se da un panorama de lo que actualmente es el arte, con énfasis en su producción como objeto y en su labor social, pues al final de esta primera parte se va perfilando, con base en el concepto de ciudad, visto desde la perspectiva de Anabel Rodrigo ( 2003,196), como sitio en el que el arte y la cultura deja de ser, y se vuelve solamente un lugar en el que se van hacinando seres humanos que se desplazan de sus propias ciudades o sitios de nacimiento, con las cuales el creador tiene que convivir, relacionarse. A partir de este concepto se desprende entonces otra particularidad, y es que se comienza desde el primer capítulo la dilucidación de diversos conceptos que ahora tienen relación con el fenómeno escénico, teatral, que sirven de base para desarrollar los siguientes capítulos. El segundo capítulo se enfoca en diversas posturas y formas de ver el teatro de calle, ya desde el aspecto didáctico, social, democrático, peyorativo o bien a partir de su realización. En este se hace hincapié y se intenta una panorámica de las diversas posturas y maneras de nombrar a esta forma teatral, con énfasis en la relación espectador-público, uno de los elementos fundantes del fenómeno, así como en el concepto de mirada y sus diferentes etapas del proceso. En el tercer capítulo se presenta un recorrido histórico de manera general por diferentes etapas del teatro de calle o bien representaciones callejeras, como el carnaval y las fiestas barrocas. En él se puede constatar que el nacimiento del teatro de calle contemporáneo y masivo, provenientes del Agitprop, que son los trabajos aquí analizados, data de finales de los sesenta y principios de los setenta; en esta parte se abordan algunas obras de los principales grupos que fueron y son guías de los nuevos grupos o bien, referentes estéticos: Living Theatre, Bread and Poupet, Teatro Campesino, Odin Theater, Comediants, Fura del’s Baus, Organización Negra, entre otros. En la cuarta parte del trabajo, “Teatro de calle en partes”, se intenta observar las particularidades de esta manera de trabajar; para esto, se enfoca en los cuatro aspectos fundamentales señalados, con base en la propuesta dramatológica de García Barrientos: Espacio, tiempo, personaje y visión. También concentra su atención en el actor como germen fundante del fenómeno escénico y en el espectador-público, como el otro elemento fundamental que garantiza la realización del fenómeno, así como en las conformaciones de trabajo y su manera de trabajar. En la última parte, “Comentarios de puestas en escena”, se encuentran veintidós comentarios de veinte compañías de diferentes partes del mundo: canadienses, francesas, italianas, españolas y mexicanas, de las cuales se rescata, una por una, la visión y el formato de teatro de calle que tales compañías proponen

DRAMATURGIA-Proyecto ADAE

Sitio web del proyecto de investigación "Análisis de la dramaturgia actual en español; Cuba, México, Argentina, España (ADAE1)". consultado el 25/04/2019.La finalidad del Proyecto es estudiar la dramaturgia que se escribe y representa actualmente, o sea, desde hace dos o tres décadas, en el ámbito de la lengua española.Ministerio de Economía y Competitividad (España), proyecto FFI2008-01536Peer reviewe

Effects of home confinement on physical activity, nutrition, and sleep quality during the COVID-19 outbreak in amateur and elite athletes

IntroductionDespite the progress in the management of the pandemic caused by COVID-19, it is necessary to continue exploring and explaining how this situation affected the athlete population around the world to improve their circumstances and reduce the negative impact of changes in their lifestyle conditions that were necessitated due to the pandemic. The aim of this study was to analyze the moderating influence of physical activity (PA) and dietary habits on the impact of the COVID-19 pandemic experience on sleep quality in elite and amateur athletes.Materials and methodsA total of 1,420 elite (40.1%) and amateur (59.9%) athletes (41% women; 59% men) from 14 different countries participated in a cross-sectional design study. Data were collected using a battery of questionnaires that identified sociodemographic data, sleep quality index, PA levels, dietary habits, and the athletes' perception of their experience during the COVID-19 pandemic. Means and standard deviations were calculated for each variable. The analysis of variances and the correlation between variables were carried out with non-parametric statistics. A simple moderation effect was calculated to analyze the interaction between PA or dietary habits on the perception of the COVID-19 experience effect on sleep quality in elite and amateur athletes.ResultsThe PA level of elite athletes was higher than amateur athletes during COVID-19 (p < 0.001). However, the PA level of both categories of athletes was lower during COVID-19 than pre-COVID-19 (p < 0.01). In addition, amateurs had a higher diet quality than elite athletes during the pandemic (p = 0.014). The perception of the COVID-19 experience as controllable was significantly higher (p = 0.020) among elite athletes. In addition, two moderating effects had significant interactions. For amateur athletes, the PA level moderated the effect of controllable COVID-19 experience on sleep quality [F(3,777) = 3.05; p = 0.028], while for elite athletes, the same effect was moderated by dietary habits [F(3,506) = 4.47, p = 0.004].ConclusionElite athletes had different lifestyle behaviors compared to amateurs during the COVID-19 lockdown. Furthermore, the relevance of maintaining high levels of PA for amateurs and good quality dietary habits by elite athletes was noted by the moderating effect that both variables had on the influence of the controllable experience during the COVID-19 pandemic on sleep quality