Complejidad y transdisciplinariedad: el desafío de los métodos centrados en la identidad

 The disciplinary separation resulting from the advancement of science and knowledge has generated biases regarding contact, understanding and action in the complexity and levels of reality. Transdisciplinarity, when calling for an examination of the real problems of the world, requires a methodological elaboration of dialogue. The epistemological level of the general methodology is not enough to direct actions of transformation, it requires the elaboration of methodologies that take into account the epistemological assumptions, the specific contexts and put actors and knowledge involved to dialogue. VETAS® Method systematizes a transdisciplinary dialogic methodology, operates as a method focused on identity, and allows applications in complex health situations, organizations and education.La separación disciplinaria resultante del avance de las ciencias y los saberes ha generado sesgos respecto del contacto, la comprensión y la acción en la complejidad y los niveles de la realidad. La transdisciplinariedad, al convocar el examen de los problemas reales del mundo, precisa una elaboración metodológica de diálogo. El nivel epistemológico de la metodología general no basta para encauzar acciones de transformación, se requiere la elaboración de metodologías que tomen en consideración los presupuestos epistemológicos, los contextos específicos y pongan a dialogar actores y saberes involucrados. El Método VETAS® sistematiza una metodología dialógica transdisciplinaria, opera como método centrado en la identidad, y permite aplicaciones en situaciones complejas de salud, las organizaciones y la educación

Transancestral mapping of the MHC region in systemic lupus erythematosus identifies new independent and interacting loci at MSH5, HLA-DPB1 and HLA-G

OBJECTIVES: Systemic lupus erythematosus (SLE) is a chronic multisystem genetically complex autoimmune disease characterised by the production of autoantibodies to nuclear and cellular antigens, tissue inflammation and organ damage. Genome-wide association studies have shown that variants within the major histocompatibility complex (MHC) region on chromosome 6 confer the greatest genetic risk for SLE in European and Chinese populations. However, the causal variants remain elusive due to tight linkage disequilibrium across disease-associated MHC haplotypes, the highly polymorphic nature of many MHC genes and the heterogeneity of the SLE phenotype. METHODS: A high-density case-control single nucleotide polymorphism (SNP) study of the MHC region was undertaken in SLE cohorts of Spanish and Filipino ancestry using a custom Illumina chip in order to fine-map association signals in these haplotypically diverse populations. In addition, comparative analyses were performed between these two datasets and a northern European UK SLE cohort. A total of 1433 cases and 1458 matched controls were examined. RESULTS: Using this transancestral SNP mapping approach, novel independent loci were identified within the MHC region in UK, Spanish and Filipino patients with SLE with some evidence of interaction. These loci include HLA-DPB1, HLA-G and MSH5 which are independent of each other and HLA-DRB1 alleles. Furthermore, the established SLE-associated HLA-DRB1*15 signal was refined to an interval encompassing HLA-DRB1 and HLA-DQA1. Increased frequencies of MHC region risk alleles and haplotypes were found in the Filipino population compared with Europeans, suggesting that the greater disease burden in non-European SLE may be due in part to this phenomenon. CONCLUSION: These data highlight the usefulness of mapping disease susceptibility loci using a transancestral approach, particularly in a region as complex as the MHC, and offer a springboard for further fine-mapping, resequencing and transcriptomic analysis

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

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p &lt; 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Pasados y presente. Estudios para el profesor Ricardo García Cárcel

Ricardo García Cárcel (Requena, 1948) estudió Historia en Valencia bajo el magisterio de Joan Reglà, con quien formó parte del primer profesorado de historia moderna en la Universidad Autónoma de Barcelona. En esta universidad, desde hace prácticamente cincuenta años, ha desarrollado una extraordinaria labor docente y de investigación marcada por un sagaz instinto histórico, que le ha convertido en pionero de casi todo lo que ha estudiado: las Germanías, la historia de la Cataluña moderna, la Inquisición, las culturas del Siglo de Oro, la Leyenda Negra, Felipe II, Felipe V, Austrias y Borbones, la guerra de la Independencia, la historia cultural, los mitos de la historia de España... Muy pocos tienen su capacidad para reflexionar, ordenar, analizar, conceptualizar y proponer una visión amplia y llena de matices sobre el pasado y las interpretaciones historiográficas. A su laboriosidad inimitable se añade una dedicación sin límites en el asesoramiento de alumnos e investigadores e impulsando revistas, dosieres, seminarios o publicaciones colectivas. Una mínima correspondencia a su generosidad lo constituye este volumen a manera de ineludible agradecimiento

Manganese Nodules in Chile, an Alternative for the Production of Co and Mn in the Future—A Review

Given the active growth of emerging technology industries, it has become essential to have large quantities of critical metals to meet the current demand. In the Chilean mining industry, there is a depletion of high-grade mineral ores, and there is hence a need to increase production levels in the copper industry and diversify its market by extracting other elements. One of the strategies is to foster the production of lithium batteries, but the manufacture requires reserves of cobalt (Co) and manganese (Mn). Currently, Co reserves are not being exploited in Chile, and Mn production is almost negligible. This is due to the apparent shortage of high-grade ores on the land surface of the country. Given this scenario, the seabed manganese nodules are presented as a good alternative due to their high average grades of Co and Mn, which in turn would allow the growth of strategic value-added industries including lithium battery production. Chile&rsquo;s current environmental regulations prevent the exploitation of marine resources. However, given technological advances worldwide, both in collection mechanisms and extractive processes, in addition to the needs generated from the future strategic plans, leads us to think about a project to exploit manganese nodules locally

Complejidad y transdisciplinariedad: el desafío de los métodos centrados en la identidad.

La separación disciplinaria resultante del avance de las ciencias y los saberes ha generado sesgos respecto del contacto, la comprensión y la acción en la complejidad y los niveles de la realidad. La transdisciplinariedad, al convocar el examen de los problemas reales del mundo, precisa una elaboración metodológica de diálogo. El nivel epistemológico de la metodología general no basta para encauzar acciones de transformación, se requiere la elaboración de metodologías que tomen en consideración los presupuestos epistemológicos, los contextos específicos y pongan a dialogar actores y saberes involucrados. El método VETAS® sistematiza una metodología dialógica transdisciplinaria, opera como método centrado en la identidad, y permite aplicaciones en situaciones complejas de salud, las organizaciones y la educación

De la “Historia sólida” a las “historias líquidas”. Los condicionantes tecnológicos y neoliberales del oficio

If for the States-Nation of the Modernity the power rooted in the territorial and demographic potential to that had access, in the Postmodern societies the power moves away of the territoriality and establishes the parameters of hierarchy in function of the speed of movement, the technological capacity and the available information. The scientific competitions of the knowledge measure in the Liquid societies by criteria of competitiveness, performance and efficiency. The educational institutions commission to boost the productivity of the researchers