Estudios culturales : prácticas diversas, enfoques pluralistas

1 archivo PDF (294 páginas) : incluye ilustracionesDesde el ámbito de los estudios culturales plantea un acercamiento teórico y metodológico multidisciplinar en el que a partir de la reflexión y el estudio de casos se analizan problemáticas reales de la historia de la cultura mexicana. Ciencia y humanismo, empirismo y reflexión son las caras de la moneda de una tendencia epistemológica que en las últimas décadas se ha planteado en el ámbito de la investigación sociológica y antropológica bajo el marbete de estudios culturales, con el objetivo de aprehender el complejo funcionamiento de los procesos culturales en las sociedades modernas. Recoge colaboraciones que abordan aspectos esenciales en el debate sobre los estudios culturales como el estado de las instituciones y la acción política, los exilios, desexilios y los movimientos migratorios entre México y Estados Unidos y sus influencias en la adaptación de los migrantes a ambos lados de la frontera, la problemática de la sexualidad y las formas de violencia, el tratamiento de la enfermedad y de la muerte, la crisis socioeconómica, el incipiente debate sobre las culturas digitales o la conciencia ecológica y medioambiental en el México de hoy. En primer lugar encontramos cuatro textos que analizan la problemática de la migración en México desde cuatro perspectivas distintas. Ana Ochoa O’Leary analiza las nuevas perspectivas de la movilización política en el sur de Estados Unidos ante los graves problemas de adaptación de los migrantes derivados de las decisiones legislativas de los últimos gobiernos nacionales y federales estadounidenses. Adriana María Eugenia Cabrera destaca la influencia de los movimientos migratorios en el patrimonio cultural de las zonas afectadas a través del estudio del proceso de identidad social del migrante y su intensa relación con los edificios históricos. También en el culto a las imágenes hay una influencia evidente del fenómeno de la migración, como muestran Pablo Martínez y María del Refugio Piña en el caso de los exvotos donados al Niño de Atocha. Política, arquitectura, antropología y también la literatura como paradigma de la migración en el trabajo de Teresita Quiroz sobre los movimientos migratorios hacia la ciudad de México en la narrativa de Mariano Azuela. El segundo apartado recoge colaboraciones bajo el epígrafe “Narratividad, discursos e identidades” en el que se mezclan perspectivas de configuración de identidades en el periodo virreinal en el estudio de Beatriz Aracil sobre el viaje de Cortés a la Mar del Sur y la transformación del sujeto colonial y reflexiones sobre lo hispano en pleno proceso de Independencia durante las primeras décadas del siglo XIX a través de artículos y monografías de Anselmo Portilla y Niceto Zamaçois planteadas por Alfredo Moreno Flores. El viaje continúa con el trabajo de Blanca Estela López y José Silvestre Revueltas sobre la narratividad para juegos y rituales, que antecede a las reflexiones literarias de Daniel Santillán sobre la identidad nacional en Margarita de Niebla, de Jaime Torres Bodet y el acercamiento a la mujer mexicana del xix a través de las referencias literarias a la lencería en cuatro autores de la época que plantea Margarita Alegría. El apartado concluye con análisis del viaje de escritores diplomáticos del XIX en China propuesto por María Fernanda García de los Arcos. “Justicia, ciudadanos y luchas sociales” propone una reflexión histórica sobre el sistema judicial y el estado de las cárceles mexicanas a partir del estudio de María Elvira Buelna y Antonio Salcedo Flores y dos ejemplos de articulación ciudadana y lucha social en los estudios de Marta Ochman y Reyna Sánchez Estévez. “Imágenes, redes y fotoperiodismo” refleja la importancia de la imagen en la sociología contemporánea y su revalorización en el estudio de textos histórico-literarios como el Diario de guerra de Simone de Beauvoir que plantea Ma. Eugenia Rabadán Villalpando y en el contexto musical hardcorero del trabajo de José A. Trejo Sánchez, que destaca la importancia de la conexión en red como emblema de pertenencia a un grupo social entre los jóvenes artistas del Valle de Toluca. “Discapacidad y muerte” enfrenta un problema crucial entre los jóvenes indígenas en Chiapas: el suicidio, a propuesta de Jorge Magaña Ochoa y debate la asistencia a niños con Síndrome de Down en el México contemporáneo en el estudio de Janeth Rojas Contreras. José Carlos Vizuete Mendoza reflexiona en el apartado “Iglesias” sobre la evolución centralizadora y descentralizadora de la estructura de gobierno, los rituales de culto, el calendario festivo y la lengua de la liturgia cristiana. Para concluir, Judith Catalina Navarro Gómez presenta en “Energía y Medio Ambiente” la problemática energética en el mundo contemporáneo y unas pautas para mejorar el medio ambiente a partir de una nueva cultura de la energía y Martha Eugenia Rodríguez y Jimena Pérez plantean un estudio de la conciencia ambiental en la ciudad de México en tres momentos históricos: siglo XVIII, siglo XIX y siglo XX y su repercusión en la salud pública

Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

Natural History of MYH7-Related Dilated Cardiomyopathy

BACKGROUND Variants in myosin heavy chain 7 (MYH7) are responsible for disease in 1% to 5% of patients with dilated cardiomyopathy (DCM); however, the clinical characteristics and natural history of MYH7-related DCM are poorly described. OBJECTIVES We sought to determine the phenotype and prognosis of MYH7-related DCM. We also evaluated the influence of variant location on phenotypic expression. METHODS We studied clinical data from 147 individuals with DCM-causing MYH7 variants (47.6% female; 35.6 +/- 19.2 years) recruited from 29 international centers. RESULTS At initial evaluation, 106 (72.1%) patients had DCM (left ventricular ejection fraction: 34.5% +/- 11.7%). Median follow-up was 4.5 years (IQR: 1.7-8.0 years), and 23.7% of carriers who were initially phenotype-negative developed DCM. Phenotypic expression by 40 and 60 years was 46% and 88%, respectively, with 18 patients (16%) first diagnosed at <18 years of age. Thirty-six percent of patients with DCM met imaging criteria for LV noncompaction. During follow-up, 28% showed left ventricular reverse remodeling. Incidence of adverse cardiac events among patients with DCM at 5 years was 11.6%, with 5 (4.6%) deaths caused by end-stage heart failure (ESHF) and 5 patients (4.6%) requiring heart transplantation. The major ventricular arrhythmia rate was low (1.0% and 2.1% at 5 years in patients with DCM and in those with LVEF of <= 35%, respectively). ESHF and major ventricular arrhythmia were significantly lower compared with LMNA-related DCM and similar to DCM caused by TTN truncating variants. CONCLUSIONS MYH7-related DCM is characterized by early age of onset, high phenotypic expression, low left ventricular reverse remodeling, and frequent progression to ESHF. Heart failure complications predominate over ventricular arrhythmias, which are rare. (C) 2022 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Clínica jurídica de acción social

Memoria ID-025. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2018-2019

Clínica jurídica de acción social

Memoria ID-0064. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2016-2017

Genome-wide association analysis of dementia and its clinical endophenotypes reveal novel loci associated with Alzheimer's disease and three causality networks : The GR@ACE project

Introduction: Large variability among Alzheimer's disease (AD) cases might impact genetic discoveries and complicate dissection of underlying biological pathways. Methods: Genome Research at Fundacio ACE (GR@ACE) is a genome-wide study of dementia and its clinical endophenotypes, defined based on AD's clinical certainty and vascular burden. We assessed the impact of known AD loci across endophenotypes to generate loci categories. We incorporated gene coexpression data and conducted pathway analysis per category. Finally, to evaluate the effect of heterogeneity in genetic studies, GR@ACE series were meta-analyzed with additional genome-wide association study data sets. Results: We classified known AD loci into three categories, which might reflect the disease clinical heterogeneity. Vascular processes were only detected as a causal mechanism in probable AD. The meta-analysis strategy revealed the ANKRD31-rs4704171 and NDUFAF6-rs10098778 and confirmed SCIMP-rs7225151 and CD33-rs3865444. Discussion: The regulation of vasculature is a prominent causal component of probable AD. GR@ACE meta-analysis revealed novel AD genetic signals, strongly driven by the presence of clinical heterogeneity in the AD series