Un abordaje de enseñanza de proporcionalidad en contexto de virtualidad

Informe final de la asignatura Metodología y Práctica de la Enseñanza. Profesorado de Matemática.El presente informe describe la experiencia de práctica profesional docente realizada por dos estudiantes de la Facultad de Matemática, Astronomía, Física y Computación (FAMAF), Universidad Nacional de Córdoba, en un tercer año de una institución pública de gestión estatal de la Ciudad de Córdoba, Argentina. La misma fue realizada virtualmente, debido al contexto social producido por la pandemia por Covid- 19. El tema abordado fue “Razones y Proporciones”. La planificación de la práctica profesional fue elaborada teniendo en cuenta las particularidades derivadas de las decisiones tomadas en diversos ámbitos del sistema educativo para el dictado virtual de clases. El trabajo contiene la planificación, la propuesta presentada para las clases de matemática y su puesta en aula, apelando a una propuesta atractiva para invitar a los estudiantes a permanecer conectados.This report describes the first professional teaching experience of two pre-service teachers from the Facultad de Matemática, Astronomía, Física y Computación (FAMAF) of the National University of Córdoba. This experience took place in the 3rd year of high school, in a public institution placed in the city of Córdoba, Argentina. This was done in virtual mode, due to the social context caused by the Covid- 19 pandemic. The addressed issue was "Reasons and Proportions". The planning of the professional practice was elaborated taking into account the particularities derived from the decisions taken in various areas of the educational system for the virtual teaching of classes. The work contains the planning, the proposal presented for the mathematics classes and their placement in the classroom, appealing to an attractive proposal to invite students to stay connected.Fil: Ramirez, Franco Anibal. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina.Fil: Tolaba, Sabrina Marisel. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; Argentina

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

Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022

Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease: Results From the CREDENCE Trial and Meta-Analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus.METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-analysis.RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (<45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]).CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02065791

Kidney and Cardiovascular Effects of Canagliflozin According to Age and Sex: A Post Hoc Analysis of the CREDENCE Randomized Clinical Trial

Rationale & Objective: It is unclear whether the effect of canagliflozin on adverse kidney and cardiovascular events in those with diabetic kid-ney disease varies by age and sex. We assessed the effects of canagliflozin among age group categories and between sexes in the Canagli-flozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) study.Study Design: Secondary analysis of a random-ized controlled trial. Setting & Participants: Participants in the CREDENCE trial. Intervention: Participants were randomly assigned to receive canagliflozin 100 mg/d or placebo.Outcomes: Primary composite outcome of kid-ney failure, doubling of serum creatinine con-centration, or death due to kidney or cardiovascular disease. Prespecified secondary and safety outcomes were also analyzed. Out-comes were evaluated by age at baseline (<60, 60-69, and >_70 years) and sex in the intention-to-treat population using Cox regression models.Results: The mean age of the cohort was 63.0 & PLUSMN; 9.2 years, and 34% were female. Older age and female sex were independently associ-ated with a lower risk of the composite of adverse kidney outcomes. There was no evidence that the effect of canagliflozin on the primary outcome (acomposite of kidney failure, a doubling of serum creatinine concentration, or death from kidney or cardiovascular causes) differed between age groups (HRs, 0.67 [95% CI, 0.52-0.87], 0.63 [0.4 8-0.82], and 0.89 [0.61-1.29] for ages <60, 60-69, and >_70 years, respectively; P = 0.3 for interaction) or sexes (HRs, 0.71 [95% CI, 0.5 4-0.95] and 0.69 [0.56-0.8 4] in women and men, respectively; P = 0.8 for interaction). No differences in safety outcomes by age group or sex were observed.Limitations: This was a post hoc analysis with multiple comparisons.Conclusions: Canagliflozin consistently reduced the relative risk of kidney events in people with diabetic kidney disease in both sexes and across age subgroups. As a result of greater background risk, the absolute reduction in adverse kidney outcomes was greater in younger participants.Funding: This post hoc analysis of the CREDENCE trial was not funded. The CREDENCE study was sponsored by Janssen Research and Development and was conducted collaboratively by the sponsor, an academic-led steering committee, and an academic research organization, George Clinical.Trial Registration: The original CREDENCE trial was registered at ClinicalTrials.gov with study number NCT02065791

Measurement of the low-energy antideuteron inelastic cross section

In this Letter, we report the first measurement of the inelastic cross section for antideuteron-nucleus interactions at low particle momenta, covering a range of 0.3 ≤ p < 4 GeV/c. The measurement is carried out using p-Pb collisions at a center-of-mass energy per nucleon–nucleon pair of $\sqrt{s_{\rm NN}}$ = 5.02 TeV, recorded with the ALICE detector at the CERN LHC and utilizing the detector material as an absorber for antideuterons and antiprotons. The extracted raw primary antiparticle-to-particle ratios are compared to the results from detailed ALICE simulations based on the geant4 toolkit for the propagation of (anti)particles through the detector material. The analysis of the raw primary (anti)proton spectra serves as a benchmark for this study, since their hadronic interaction cross sections are well constrained experimentally. The first measurement of the inelastic cross section for antideuteron-nucleus interactions averaged over the ALICE detector material with atomic mass numbers ⟨A⟩ = 17.4 and 31.8 is obtained. The measured inelastic cross section points to a possible excess with respect to the Glauber model parametrization used in geant4 in the lowest momentum interval of 0.3 ≤ p < 0.47 GeV/c up to a factor 2.1. This result is relevant for the understanding of antimatter propagation and the contributions to antinuclei production from cosmic ray interactions within the interstellar medium. In addition, the momentum range covered by this measurement is of particular importance to evaluate signal predictions for indirect dark-matter searches

Elliptic Flow of Electrons from Beauty-Hadron Decays in Pb-Pb Collisions at sNN\sqrt {s_{NN}} = 5.02 TeV

The elliptic flow of electrons from beauty hadron decays at midrapidity (|y|<0.8) is measured in Pb-Pb collisions at $\sqrt {s_{NN}}$ = 5.02 TeV with the ALICE detector at the LHC. The azimuthal distribution of the particles produced in the collisions can be parametrized with a Fourier expansion, in which the second harmonic coefficient represents the elliptic flow, $v_2$. The $v_2$ coefficient of electrons from beauty hadron decays is measured for the first time in the transverse momentum ($p_T$) range 1.3–6 GeV/c in the centrality class 30%–50%. The measurement of electrons from beauty-hadron decays exploits their larger mean proper decay length cτ ≈ 500 μm compared to that of charm hadrons and most of the other background sources. The $v_2$ of electrons from beauty hadron decays at midrapidity is found to be positive with a significance of 3.75 σ. The results provide insights into the degree of thermalization of beauty quarks in the medium. A model assuming full thermalization of beauty quarks is strongly disfavored by the measurement at high $p_T$, but is in agreement with the results at low $p_T$. Transport models including substantial interactions of beauty quarks with an expanding strongly interacting medium describe the measurement within uncertainties

J/ψ\psi production as a function of charged-particle multiplicity in p-Pb collisions at sNN = 8.16\sqrt{\textit{s}_{\rm NN}}~=~8.16 TeV

Inclusive J/ψ yields and average transverse momenta in p-Pb collisions at a center-of-mass energy per nucleon pair $\sqrt{s_{\mathrm{NN}}}$ = 8.16 TeV are measured as a function of the charged-particle pseudorapidity density with ALICE. The J/ψ mesons are reconstructed at forward (2.03 < y$_{cms}$< 3.53) and backward (−4.46 < y$_{cms}$< −2.96) center-of-mass rapidity in their dimuon decay channel while the charged-particle pseudorapidity density is measured around midrapidity. The J/ψ yields at forward and backward rapidity normalized to their respective average values increase with the normalized charged-particle pseudorapidity density, the former showing a weaker increase than the latter. The normalized average transverse momenta at forward and backward rapidity manifest a steady increase from low to high charged-particle pseudorapidity density with a saturation beyond the average value

Measurement of nuclear effects on ψ(2S)\psi\rm{(2S)} production in p-Pb collisions at sNN=8.16\sqrt{\textit{s}_{\rm NN}} = 8.16 TeV

Inclusive ψ(2S) production is measured in p-Pb collisions at the centre-of-mass energy per nucleon-nucleon pair $\sqrt{s_{\mathrm{NN}}}$ = 8.16 TeV, using the ALICE detector at the CERN LHC. The production of ψ(2S) is studied at forward (2.03 < y$_{cms}$< 3.53) and backward (−4.46 < y$_{cms}$< −2.96) centre-of-mass rapidity and for transverse momentum p$_{T}$< 12 GeV/c via the decay to muon pairs. In this paper, we report the integrated as well as the y$_{cms}$- and p$_{T}$-differential inclusive production cross sections. Nuclear effects on ψ(2S) production are studied via the determination of the nuclear modification factor that shows a strong suppression at both forward and backward centre-of-mass rapidities. Comparisons with corresponding results for inclusive J/ψ show a similar suppression for the two states at forward rapidity (p-going direction), but a stronger suppression for ψ(2S) at backward rapidity (Pb-going direction). As a function of p$_{T}$, no clear dependence of the nuclear modification factor is found. The relative size of nuclear effects on ψ(2S) production compared to J/ψ is also studied via the double ratio of production cross sections [σ$_{ψ(2S)}$/σ$_{J/ψ}$]pPb/[σ$_{ψ(2S)}$/σ$_{J/ψ}$]$_{pp}$ between p-Pb and pp collisions. The results are compared with theoretical models that include various effects related to the initial and final state of the collision system and also with previous measurements at $\sqrt{s_{\mathrm{NN}}}$ = 5.02 TeV.[graphic not available: see fulltext]Inclusive $\psi$(2S) production is measured in p-Pb collisions at the centre-of-mass energy per nucleon-nucleon pair $\sqrt{s_{\rm{NN}}}=8.16$ TeV, using the ALICE detector at the CERN LHC. The production of $\psi$(2S) is studied at forward ($2.03 < y_{\rm cms} < 3.53$) and backward ($-4.46 < y_{\rm cms} < -2.96$) centre-of-mass rapidity and for transverse momentum $p_{\rm{T}}$ $<$ 12 GeV/$c$ via the decay to muon pairs. In this paper, we report the integrated as well as the $y_{\rm cms}$- and $p_{\rm T}$-differential inclusive production cross sections. Nuclear effects on $\psi$(2S) production are studied via the determination of the nuclear modification factor that shows a strong suppression at both forward and backward centre-of-mass rapidities. Comparisons with corresponding results for inclusive J/$\psi$ show a similar suppression for the two states at forward rapidity (p-going direction), but a stronger suppression for $\psi$(2S) at backward rapidity (Pb-going direction). As a function of $p_{\rm T}$, no clear dependence of the nuclear modification factor is found. The relative size of nuclear effects on $\psi$(2S) production compared to J/$\psi$ is also studied via the double ratio of production cross sections $[\sigma_{\psi(2S)}/\sigma_{\rm{J/}\psi}]_{\rm pPb}/[\sigma_{\psi(2S)}/\sigma_{\rm{J/}\psi}]_{\rm pp}$ between p-Pb and pp collisions. The results are compared with theoretical models that include various effects related to the initial and final state of the collision system and also with previous measurements at $\sqrt{s_{\rm{NN}}}$ = 5.02 TeV