Clash silábico y desplazamiento acentual en el español canario

El clash silábico se produce por la sucesión o proximidad de dos o más sílabas fuertes, como en el inglés thir´teen ´men, ´three ´red ´shirts, en el español pri´mer ´niño, ´tu ´das ´todo, en el sueco Kap´ten ´Andersson, y así en otras muchas lenguas. Los estudios fonéticos y fonológicos han considerado que secuencias como las propuestas resultarían cacofónicas o poco naturales, por lo que los hablantes de cualquier lengua disponen de toda una serie de recursos destinados a evitarlas: retracción acentual, alargamiento o acortamiento de una de las sílabas tónicas, inserción de una pausa entre las sílabas fuertes, etc. El propósito de este estudio es comprobar si los hispanohablantes canarios utilizan el cambio de posición de los acentos léxicos como un modo de evitar el clash. Con el fin de determinar, además, si existe algún tipo de relación entre Fonología y Sintaxis, se ha trabajado con dos tipos de estructuras sintácticas: el SN y la oración (SN + SV). Los índices acústicos analizados fueron el tiempo, el tono y la intensidad. Los valores obtenidos fueron sometidos a un tratamiento estadístico (análisis de Anova).Syllabic clash takes place when two or more strong syllables are in succession or in vicinity in a spoken sequence. For example, in English thir´teen ´men, ´three ´red ´shirts, in Spanish pri´mer ´niño, ´tu ´das ´todo, in Swedish Kap´ten ´Andersson, and so forth in many languages. Phonetic and phonological studies have considered that sequences like these are cacophonous or not natural. For that reason speakers of any language have an entire series of resources dedicated to avoid them: stress shift, lengthening or reduction of one of the stressed syllables, insertion of a pause between the strong syllables, etc. The purpose of this study is to check the use of stress shift as a way of avoiding the clash in the Canarian Spanish speech. Acoustical cues analyzed were time, pitch and intensity. Values obtained were subjected to a statistical treatment (analysis of Anova).El clash silábico se produce por la sucesión o proximidad de dos o más sílabas fuertes, como en el inglés thir´teen ´men, ´three ´red ´shirts, en el español pri´mer ´niño, ´tu ´das ´todo, en el sueco Kap´ten ´Andersson, y así en otras muchas lenguas. Los estudios fonéticos y fonológicos han considerado que secuencias como las propuestas resultarían cacofónicas o poco naturales, por lo que los hablantes de cualquier lengua disponen de toda una serie de recursos destinados a evitarlas: retracción acentual, alargamiento o acortamiento de una de las sílabas tónicas, inserción de una pausa entre las sílabas fuertes, etc. El propósito de este estudio es comprobar si los hispanohablantes canarios utilizan el cambio de posición de los acentos léxicos como un modo de evitar el clash. Con el fin de determinar, además, si existe algún tipo de relación entre Fonología y Sintaxis, se ha trabajado con dos tipos de estructuras sintácticas: el SN y la oración (SN + SV). Los índices acústicos analizados fueron el tiempo, el tono y la intensidad. Los valores obtenidos fueron sometidos a un tratamiento estadístico (análisis de Anova)

Tratamiento impositivo de construcción y venta de inmuebles

En el presente trabajo se desarrolla el tratamiento impositivo de los principales tributos nacionales en la construcción y venta de bienes inmuebles para las distintas situaciones que pueden presentarse en la realidad económica y cómo afectan a los diferentes sujetos pasivos.Fil: Blanch, Rodrigo. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas.Fil: López, Ramiro. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas.Fil: San Esteban, Juan Manuel. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas.Fil: Ullrich, Bernardo. Universidad Nacional de Cuyo. Facultad de Ciencias Económicas

Prevalence and Geographic Variations in Asthma Symptoms in Children and Adolescents in Galicia (Spain)

[Resumen] Objetivos. Determinar la prevalencia y variaciones geográficas de síntomas relacionados con asma en niños y adolescentes gallegos. Población y métodos. Estudio transversal según la metodología ISAAC (Internacional Study of Asthma and Allergies in Childhood) mediante cuestionario escrito distribuido en el medio escolar. Se incluyeron 10.371 niños de 6-7 años y 10.372 adolescentes de 13-14 años de todas las Áreas Sanitarias de Galicia. Se analizaron las variaciones geográficas mediante un modelo de regresión logística. Resultados. Las sibilancias en los últimos 12 meses oscilaron en los pequeños, del 11,4 (Santiago) al 15,7% (Vigo) y en los adolescentes del 8,8 (Ourense) al 18,8% (Vigo). Según el género se observó una mayor frecuencia en varones de 6-7 años (p < 0,001) y con tendencia a la significación estadística en las chicas de 13-14 años (p = 0,08). El riesgo (Odds ratio [OR]) de sibilancias en los últimos 12 meses, en el área de mayor prevalencia con respecto a la de menor, fue 1,45 (intervalo de confianza [IC] del 95%: 1,12-1,88) en niños y 2,39 (IC 95%: 1,82-3,13) en adolescentes. La prevalencia de asma estimada para Galicia fue de 13,6% en niños y 12,2% en adolescentes. Conclusiones. La prevalencia de sibilancias en los últimos 12 meses en las diferentes áreas gallegas es sensiblemente superior al resto de ciudades españolas participantes en el ISAAC en los pequeños, siendo muy similar en los adolescentes, salvo en Vigo donde es sensiblemente superior. Encontramos un patrón geográfico muy definido en los adolescentes, siendo mayores las prevalencias en la costa que en el interior.[Abstract] Objectives. To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. Population and methods. A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. Results. In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P < .001), and near to be statistically significant in 13-14 year-old females (P = .08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area with highest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval [CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthma in the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents. Conclusions. The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerably higher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 years group, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern in the adolescent group, with higher prevalences in coastal areas than in the interior

Genetic diversity of HLA system in four populations from Baja California, Mexico: Mexicali, La Paz, Tijuana and rural Baja California

We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 250 Mexicans from the states of Baja California Norte and Baja California Sur living in Mexicali (N = 100), La Paz (N = 75), Tijuana (N = 25) and rural communities (N = 50) to obtain information regarding allelic and haplotypic frequencies. The most frequent haplotypes for the Baja California region include nine Native American and five European haplotypes. Admixture estimates revealed that the main genetic components are European (50.45 ± 1.84% by ML; 42.03% of European haplotypes) and Native American (43.72 ± 2.36% by ML; 40.24% of Native American haplotypes), while the African genetic component was less apparent (5.83 ± 0.98% by ML; 9.36% of African haplotypes)

Usefulness of bone turnover markers as predictors of mortality risk, disease progression and skeletal-related events appearance in patients with prostate cancer with bone metastases following treatment with zoledronic acid: TUGAMO study

Owing to the limited validity of clinical data on the treatment of prostate cancer (PCa) and bone metastases, biochemical markers are a promising tool for predicting survival, disease progression and skeletal-related events (SREs) in these patients. The aim of this study was to evaluate the predictive capacity of biochemical markers of bone turnover for mortality risk, disease progression and SREs in patients with PCa and bone metastases undergoing treatment with zoledronic acid (ZA). Methods: This was an observational, prospective and multicenter study in which ninety-eight patients were included. Patients were treated with ZA (4mg every 4 weeks for 18 months). Data were collected at baseline and 3, 6, 9, 12, 15 and 18 months after the beginning of treatment. Serum levels of bone alkaline phosphtase (BALP), aminoterminal propeptide of procollagen type I (P1NP) and beta-isomer of carboxiterminal telopeptide of collagen I (b-CTX) were analysed at all points in the study. Data on disease progression, SREs development and survival were recorded. Results: Cox regression models with clinical data and bone markers showed that the levels of the three markers studied were predictive of survival time, with b-CTX being especially powerful, in which a lack of normalisation in visit 1 (3 months after the beginning of treatment) showed a 6.3-times more risk for death than in normalised patients. Levels of these markers were also predictive for SREs, although in this case BALP and P1NP proved to be better predictors. We did not find any relationship between bone markers and disease progression. Conclusion: In patients with PCa and bone metastases treated with ZA, b-CTX and P1NP can be considered suitable predictors for mortality risk, while BALP and P1NP are appropriate for SREs. The levels of these biomarkers 3 months after the beginning of treatment are especially importantThis study was supported by Novartis Oncology Spai

Prevalencia de síntomas de asma en los niños y adolescentes de la Comunidad Autónoma de Galicia (España) y sus variaciones geográficas

OBJECTIVES: To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. POPULATION AND METHODS: A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. RESULTS: In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P<.001), and near to be statistically significant in 13-14 year-old females (P=.08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area with highest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval [CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthma in the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents. CONCLUSIONS: The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerably higher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 years group, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern in the adolescent group, with higher prevalences in coastal areas than in the interior

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

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Efficacy of clozapine versus standard treatment in adult individuals with intellectual disability and treatment-resistant psychosis (CLOZAID): study protocol of a multicenter randomized clinical trial

BackgroundIntellectual disability (ID) affects approximately 1% of the worldwide population and individuals with ID have a higher comorbidity with mental illness, and specifically psychotic disorders. Unfortunately, among individuals with ID, limited research has been conducted since ID individuals are usually excluded from mental illness epidemiological studies and clinical trials. Here we perform a clinical trial to investigate the effectiveness of clozapine in the treatment of resistant psychosis in individuals with ID. The article highlights the complexity of diagnosing and treating psychopathological alterations associated with ID and advocates for more rigorous research in this field.MethodsA Phase IIB, open-label, randomized, multicenter clinical trial (NCT04529226) is currently ongoing to assess the efficacy of oral clozapine in individuals diagnosed with ID and suffering from treatment-resistant psychosis. We aim to recruit one-hundred and fourteen individuals (N=114) with ID and resistant psychosis, who will be randomized to TAU (treatment as usual) and treatment-with-clozapine conditions. As secondary outcomes, changes in other clinical scales (PANSS and SANS) and the improvement in functionality, assessed through changes in the Euro-QoL-5D-5L were assessed. The main outcome variables will be analyzed using generalized linear mixed models (GLMM), assessing the effects of status variable (TAU vs. Clozapine), time, and the interaction between them.DiscussionThe treatment of resistant psychosis among ID individuals must be directed by empirically supported research. CLOZAID clinical trial may provide relevant information about clinical guidelines to optimally treat adults with ID and treatment-resistant psychosis and the benefits and risks of an early use of clozapine in this underrepresented population in clinical trials.Trial registrationClinicaltrials.gov: NCT04529226. EudraCT: 2020-000091-37