Bloqueo según modalidad de estímulo en CEE: dificultades en la enseñanza con pictogramas

It has been observed that the use of pictures interferes when teaching novel words. We sought to extend these results to Stimulus Equivalence Classes (SEC), investigating whether the blocking effect occurs differentially according to the modality of the blocked stimulus (i.e. pictorial or pseudo-lexical). Ten university students were trained, by matching to sample, in four SEC (two of pseudo-lexical modality and two of pictorial modality). A blocking procedure was applied during the same training. Emergence of derived relationships for each element of the compound stimuli was separately evaluated. A greater blocking effect was observed whenever the blocking stimulus X was of pseudo-lexical modality. Results are discussed regarding associative theories, as well as its implications in the development of pedagogical practices. The results observed discourage the use of images in compound stimuli for the teaching of novel wordsSe ha observado que el uso de imágenes interfiere en el aprendizaje de palabras novedosas. Se buscó extender estos resultados a Clases de Equivalencia de Estímulo (CEE), indagando si el efecto de bloqueo se presenta de manera diferencial según la modalidad del estímulo bloqueado (i.e. pictórico o pseudo-lexical). Diez estudiantes universitarios fueron entrenados, mediante igualación a la muestra, en cuatro CEE (dos de modalidad pseudo-lexical y dos de modalidad pictórica). En el mismo entrenamiento se aplicó un procedimiento de bloqueo. Se evaluó la emergencia de relaciones derivadas para cada elemento de los estímulos compuestos por separado. Un mayor efecto de bloqueo fue observado siempre que el estímulo bloqueado X fue de modalidad pseudo-lexical. Se discuten los resultados en relación a las teorías de emparejamiento de estímulos y su implicancia en el desarrollo de prácticas pedagógicas. Los resultados observados desalientan el uso de estímulos compuestos para la enseñanza de palabras

Women in (Dis)placement: The Field of Studies on Migrations, Social Remittances, Care and Gender in Chile

This article presents current perspectives on the gender approach to the study of migration in Chile between 1990 and 2018, contextualizing it in light of international debates in the social sciences. We will discuss how the feminization and the growth of Latin American migrations have given rise to a prolific field of research, as exemplified by studies conducted in central and northern Chile. We will show how the concepts of social remittances and caregiving permeate the Chilean debate on migrant women. We conclude with reflections on topics and perspectives to be incorporated into the Chilean research agenda on gender and migration.Se presenta un estado del arte sobre el enfoque de género en los estudios de la migración en Chile entre 1990 y 2018, contextualizándolo a la luz de debates internacionales de las ciencias sociales. Abordaremos cómo la feminización y el incremento de las migraciones latinoamericanas inauguran un prolijo campo de investigaciones, articulado a través de estudios desarrollados en el centro y en el norte de Chile. Señalaremos cómo los conceptos de remesas sociales y cuidados permean el debate chileno sobre las mujeres migrantes. Finalizamos con reflexiones sobre temas y perspectivas a ser incorporados en la agenda chilena de investigaciones sobre género y migración.The authors would like to thank the Chilean National Commission for Scientific and Technological Research (CONICYT) for funding the study that led to this article through Fondecyt Regular Project number 1160683: “Ser Mujer Mayor en Santiago. Organización social de los cuidados, feminización del envejecimiento y desigualdades acumuladas” (“Being an older woman in Santiago. Social organization of care, feminization of ageing and accumulated inequalities”), led by Herminia Gonzálvez Torralbo and Fondecyt Regular Project number 1190056: “The Boundaries of Gender Violence: Migrant Women’s Experiences in South American Border Territories” led by Menara Lube Guizardi

Bloqueo según modalidad de estímulo en CEE: dificultades en la enseñanza con pictogramas

Blocking and Stimulus Modality in CEE: difficulties in teaching with pictograms. It has been observed that the use of pictures interferes when teaching novel words. We sought to extend these results to Stimulus Equivalence Classes (SEC), investigating whether the blocking effect occurs differentially according to the modality of the blocked stimulus (i.e. pictorial or pseudo-lexical). Ten university students were trained, by matching to sample, in four SEC (two of pseudo-lexical modality and two of pictorial modality). A blocking procedure was applied during the same training. Emergence of derived relationships for each element of the compound stimuli was separately evaluated. A greater blocking effect was observed whenever the blocking stimulus X was of pseudo-lexical modality. Results are discussed regarding associative theories, as well as its implications in the development of pedagogical practices. The results observed discourage the use of images in compound stimuli for the teaching of novel wordsSe ha observado que el uso de imágenes interfiere en el aprendizaje de palabras novedosas. Se buscó extender estos resultados a Clases de Equivalencia de Estímulo (CEE), indagando si el efecto de bloqueo se presenta de manera diferencial según la modalidad del estímulo bloqueado (i.e. pictórico o pseudo-lexical). Diez estudiantes universitarios fueron entrenados, mediante igualación a la muestra, en cuatro CEE (dos de modalidad pseudo-lexical y dos de modalidad pictórica). En el mismo entrenamiento se aplicó un procedimiento de bloqueo. Se evaluó la emergencia de relaciones derivadas para cada elemento de los estímulos compuestos por separado. Un mayor efecto de bloqueo fue observado siempre que el estímulo bloqueado X fue de modalidad pseudo-lexical. Se discuten los resultados en relación a las teorías de emparejamiento de estímulos y su implicancia en el desarrollo de prácticas pedagógicas. Los resultados observados desalientan el uso de estímulos compuestos para la enseñanza de palabras

Behavioral and neurophysiological signatures of interoceptive enhancements following vagus nerve stimulation

An accruing body of research has shown that interoception (the sensing of signals from the body's internal milieu) relies on both a direct route (afforded by the vagus nerve) and a secondary route (supported by somatosensory mechanisms). However, no study has causally tested the differential role of these pathways, let alone via direct stimulation. To bridge this gap, we tested whether multidimensional signatures of interoception are modulated by noninvasive vagus nerve stimulation (nVNS). Sixty-three participants were divided into an nVNS and a sham-stimulation group. Before and after stimulation, both groups performed a validated heartbeat detection (HBD) task including a genuinely interoceptive condition (monitoring one's own heartbeat) and a control exteroceptive condition (tracking an aurally presented heartbeat). Electroencephalographic signals were obtained during both conditions to examine modulations of the heartbeat-evoked potential (HEP). Moreover, before and after stimulation, participants were asked to complete a somatosensory heartbeat localization task. Results from the interoceptive condition revealed that, after treatment, only the nVNS group exhibited improved performance and greater HEP modulations. No behavioral differences were found for the exteroceptive control condition, which was nonetheless associated with significant HEP modulations. Finally, no between-group differences were observed regarding the localization of the heartbeat sensations or relevant cardiodynamic variables (heart rate and or heart rate variability). Taken together, these results constitute unprecedented evidence that the vagus nerve plays a direct role in neurovisceral integration during interoception. This finding can constrain mechanistic models of the domain while informing a promising transdiagnostic agenda for interoceptive impairments across neuropsychiatric conditions

Fatigue in multiple sclerosis is associated with multimodal interoceptive abnormalities

Background: Fatigue ranks among the most common and disabling symptoms in multiple sclerosis (MS). Recent theoretical works have surmised that this trait might be related to alterations across interoceptive mechanisms. However, this hypothesis has not been empirically evaluated. Objectives: To determine whether fatigue in MS patients is associated with specific behavioral, structural, and functional disruptions of the interoceptive domain. Methods: Fatigue levels were established via the Modified Fatigue Impact Scale. Interoception was evaluated through a robust measure indexed by the heartbeat detection task. Structural and functional connectivity properties of key interoceptive hubs were tested by magnetic resonance imaging (MRI) and resting-state functional MRI. Machine learning analyses were employed to perform pairwise classifications. Results: Only patients with fatigue presented with decreased interoceptive accuracy alongside decreased gray matter volume and increased functional connectivity in core interoceptive regions, the insula, and the anterior cingulate cortex. Each of these alterations was positively associated with fatigue. Finally, machine-learning analysis with a combination of the above interoceptive indices (behavioral, structural, and functional) successfully discriminated (area under the curve > 90%) fatigued patients from both non-fatigued and healthy controls. Conclusion: This study offers unprecedented evidence suggesting that disruptions of neurocognitive markers subserving interoception may constitute a signature of fatigue in MS

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes

Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021

Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimates of diabetes prevalence and burden from 1990 to 2021, the proportion of type 1 and type 2 diabetes in 2021, the proportion of the type 2 diabetes burden attributable to selected risk factors, and projections of diabetes prevalence through 2050. Methods: Estimates of diabetes prevalence and burden were computed in 204 countries and territories, across 25 age groups, for males and females separately and combined; these estimates comprised lost years of healthy life, measured in disability-adjusted life-years (DALYs; defined as the sum of years of life lost [YLLs] and years lived with disability [YLDs]). We used the Cause of Death Ensemble model (CODEm) approach to estimate deaths due to diabetes, incorporating 25 666 location-years of data from vital registration and verbal autopsy reports in separate total (including both type 1 and type 2 diabetes) and type-specific models. Other forms of diabetes, including gestational and monogenic diabetes, were not explicitly modelled. Total and type 1 diabetes prevalence was estimated by use of a Bayesian meta-regression modelling tool, DisMod-MR 2.1, to analyse 1527 location-years of data from the scientific literature, survey microdata, and insurance claims; type 2 diabetes estimates were computed by subtracting type 1 diabetes from total estimates. Mortality and prevalence estimates, along with standard life expectancy and disability weights, were used to calculate YLLs, YLDs, and DALYs. When appropriate, we extrapolated estimates to a hypothetical population with a standardised age structure to allow comparison in populations with different age structures. We used the comparative risk assessment framework to estimate the risk-attributable type 2 diabetes burden for 16 risk factors falling under risk categories including environmental and occupational factors, tobacco use, high alcohol use, high body-mass index (BMI), dietary factors, and low physical activity. Using a regression framework, we forecast type 1 and type 2 diabetes prevalence through 2050 with Socio-demographic Index (SDI) and high BMI as predictors, respectively. Findings: In 2021, there were 529 million (95% uncertainty interval [UI] 500-564) people living with diabetes worldwide, and the global age-standardised total diabetes prevalence was 6·1% (5·8-6·5). At the super-region level, the highest age-standardised rates were observed in north Africa and the Middle East (9·3% [8·7-9·9]) and, at the regional level, in Oceania (12·3% [11·5-13·0]). Nationally, Qatar had the world's highest age-specific prevalence of diabetes, at 76·1% (73·1-79·5) in individuals aged 75-79 years. Total diabetes prevalence-especially among older adults-primarily reflects type 2 diabetes, which in 2021 accounted for 96·0% (95·1-96·8) of diabetes cases and 95·4% (94·9-95·9) of diabetes DALYs worldwide. In 2021, 52·2% (25·5-71·8) of global type 2 diabetes DALYs were attributable to high BMI. The contribution of high BMI to type 2 diabetes DALYs rose by 24·3% (18·5-30·4) worldwide between 1990 and 2021. By 2050, more than 1·31 billion (1·22-1·39) people are projected to have diabetes, with expected age-standardised total diabetes prevalence rates greater than 10% in two super-regions: 16·8% (16·1-17·6) in north Africa and the Middle East and 11·3% (10·8-11·9) in Latin America and Caribbean. By 2050, 89 (43·6%) of 204 countries and territories will have an age-standardised rate greater than 10%. Interpretation: Diabetes remains a substantial public health issue. Type 2 diabetes, which makes up the bulk of diabetes cases, is largely preventable and, in some cases, potentially reversible if identified and managed early in the disease course. However, all evidence indicates that diabetes prevalence is increasing worldwide, primarily due to a rise in obesity caused by multiple factors. Preventing and controlling type 2 diabetes remains an ongoing challenge. It is essential to better understand disparities in risk factor profiles and diabetes burden across populations, to inform strategies to successfully control diabetes risk factors within the context of multiple and complex drivers. Funding: Bill & Melinda Gates Foundation