De lo familiar y lo perverso. La poética de Laura Contreras

Más allá de las pretensiones de la artista, creo que la función de los cuadros de Laura es inquietarnos. A partir del ensimismamiento que nos produce la solvencia técnica y la destreza de las formas que constituyen su discurso, reconocemos lo que se nos presenta —en un inicio bajo la convención del cuadro/escena, o ventana del mundo— como algo extraño y familiar a la vez. Los signos que identificamos nos hablan de lo ya conocido, sin embargo, son fruto de una imaginación desbordada que pretende comunicar su angustia y que, por lo tanto, elabora un corpus plástico con características tan ricas y complejas como lo requiere cada particular deseo expresado. Estas escenas tienen su origen en el universo oscuro, cerrado, pastoso de la familia clasemediera de pueblo. La arquitectura de la casa delimita y sintetiza los motivos que celebran de manera simbólica la ideología, las costumbres y, en cierta manera, el modo de ser de las relaciones que se establecen entre los habitantes de ese espacio. En la forma de decorar y hasta en el color de las paredes se manifiesta la manía de llenarlo todo —desde los cuadros y diplomas familiares, las fotos de bodas, de fiestas de quince años y de graduaciones escolares, hasta las figuras decorativas, las carpetas para muebles, el mobiliario sencillo y mimético con respecto al conjunto, etc.—. Todas esas existencias adoptadas como iconografía fueron el hogar de las primeras miradas infantiles de Laura, las cuales le infundieron la idea de que así es el mundo. Ahora, la parte oscura de ese universo familiar, las ideas silenciosas que se desplazan en el aire hogareño acerca de la muerte, de los valores familiares y sociales, se enlazan con el arte

El paisaje como destino. El Acueducto del Padre Tembleque. Patrimonio Cultural de la Humanidad

Vestigio del esfuerzo humano, el Acueducto del Padre Tembleque representa la conjugación de ideales y saberes con un objetivo imprescindible: la modificación de un entorno natural magnífico, pero que se ha tornado hostil. En una época de reconfiguración de un país que se debate entre la grandeza de un pasado que permanece sólo en la memoria y un porvenir incierto y prefigurado por las necesidades más inmediatas. El Acueducto del Padre Tembleque es una maravillosa obra que vincula saberes diversos de distintas épocas, desde la ingeniería romana a la arquitectura renacentista, y milenarios conocimientos constructivos mesoamericanos que permanecen latentes. La técnica, los materiales y el trabajo de cientos de manos anónimas transformaron —en el siglo xvi— un territorio que hoy prevalece inerte bajo la vida de su rica naturaleza que, sin embargo, permanece oculta en medio de la tensión entre la industrialización, el desarrollo y las formas de vida que conservan la referencia a tradiciones y costumbres que reclaman su vigencia. A lo largo de cada uno de sus 48 kilómetros, la presencia de esta obra hidráulica se funde con el contexto natural hasta convertirse en el eje de la construcción de un singular paisaje que demanda la atención sobre múltiples elementos que lo constituyen, entre ellos: arcadas, impresionantes arcos, pueblos y caseríos, aljibes y cajas de agua, iglesias y capillas, depósitos naturales y artificiales del vital líquido, manantiales, cerros, montes y peñascos, arroyos y un río, sembradíos de temporal y especialmente, una flora diversa y peculiar enmarcada por magueyes y nopales del altiplano que hacen único este territorio limítrofe entre los estados de México e Hidalgo. Son las relaciones espaciales y vitales de estos elementos —ocultos y visibles—, las que conforman el verdadero paisaje, aquel que se extiende horizontal y emotivamente a la vista y a los sentimientos, y que logra ampliar su influencia sensible a través de la lente. La fotografía, como horizonte artístico, devela modos inéditos de interactuar este paisaje; crea una idea propia a partir de la experiencia colectiva entre el acueducto y el entorno del que es parte. Recientemente, gracias al impulso y al trabajo que ha venido realizando en materia de preservación de nuestras riquezas naturales y arquitectónicas el gobierno de la república, encabezado por el Lic. Enrique Peña Nieto, así como por la iniciativa y la labor del gobierno del Estado de México, que preside el Dr. Eruviel Ávila Villegas, este importante sistema hidráulico del siglo xvi recibió el Certificado que lo acredita como Patrimonio Mundial de la unesco. Mi reconocimiento por su amplia visión y vocación de servicio a los mexicanos y especialmente a los mexiquenses. Para la Universidad Autónoma del Estado de México ha sido un asunto primordial participar en la inscripción del Acueducto del Padre Tembleque en el Patrimonio Mundial de la unesco, situación que nos compromete a seguir desarrollando proyectos que investiguen, valoren y difundan la enorme riqueza cultural de nuestro país, entendida como un patrimonio que, en su divulgación, busque hacer coincidir las distintas miradas acerca de nuestra identidad

PROBLEMÁTICAS FORMALES DEL DIBUJO

CUADERNO DE EJERCICIOS Y/O PROBLEMARI

MANUAL BASICO DE LITOGRAFIA

MANUAL PARA PRACTICAS DE LABORATORIO, TALLER U OTRA AREA DE APOYO A LA DOCENCI

Pre-dilation and Post-dilation in Transcatheter Aortic Valve Replacement: Indications, Benefits and Risks

Transcatheter aortic valve replacement (TAVR) is an established treatment for patients with symptomatic severe aortic stenosis. In recent years, an emphasis has been placed on simplification of the procedure. Balloon predilation was initially considered a mandatory step to cross and prepare the stenotic aortic valve, but several studies demonstrated the feasibility of performing TAVR without balloon valvuloplasty. Balloon postdilation of the implanted valve is sometimes required to optimise results, although many patients do not require this step. Contemporary consensus advocates an individualised approach to TAVR procedures and so balloon pre- and post-dilation are performed selectively. This review aims to outline the advantages and disadvantages of balloon pre- and post-dilation and to identify the scenarios in which they are required during TAVR procedures

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

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality