La Argumentación Oral: desde textos y contextos a partir de la implementación de una secuencia didáctica.

RESUMEN: Este trabajo de profundización se realizó para evaluar la implementación de una secuencia didáctica orientada al mejoramiento de la argumentación oral desde textos y contextos en los estudiantes del grado noveno de la Institución Educativa Pedro Estrada (IEPE) y la Institución Educativa Rural Ovejas (IERO), bajo el Paradigma Cualitativo posibilitando estructurar o desestructurar las formas de argumentar de los estudiantes con la participación e intervención del docente, a partir de la Investigación Acción Pedagógica. La Investigación Acción Pedagógica, permitió reflexionar, sistematizar y analizar información referida a los Movimientos Argumentativos (MA), a los textos y contextos que emplearon los estudiantes en sus enunciados orales. Se implementaron estrategias como la observación directa, grabación de audios de las intervenciones, escritos y testimonios de una muestra aleatoria de los estudiantes que participaron en las sesiones de la secuencia didáctica (SD), diseñada para acercar conscientemente a los jóvenes a experiencias argumentativas. Los hallazgos de la investigación permitieron confirmar que los estudiantes muestran gusto y seguridad al participar en actividades donde pueden exponer sus ideas, opiniones y argumentaciones en forma oral, incorporando en su discurso recursos del lenguaje para expresar y dar a entender sus ideas. Este trabajo de profundización promovió, mediante la implementación de la secuencia didáctica como estrategia pedagógica la transformación de los procesos discursivos en el aula como escenario de interacción y diálogo, favoreciendo así, el empoderamiento de la palabra, la construcción de conocimiento y del ser ciudadano.ABSTRACT: This deepening work was carried out to evaluate the implementation of a didactic sequence oriented to the improvement of oral argumentation from texts and contexts in the ninth grade students of the Pedro Estrada Educational Institution (IEPE) and the Rural Educational Institution Ovejas (IERO), under the Qualitative Paradigm making it possible to structure or de-structure the ways of arguing of the students with the participation and intervention of the teacher, from the Pedagogical Action Research. The Pedagogical Action Research, allowed to reflect, systematize and analyze information referring to the Argumentative Movements (MA), to the texts and contexts that the students used in their oral statements. Strategies were implemented, such as direct observation, audio recording of the interventions, writings and testimonies of a random sample of the students who participated in the sessions of the didactic sequence (SD), designed to consciously approach young people to argumentative experiences. The findings of the research allowed confirming that students show taste and safety by participating in activities where they can present their ideas, opinions and arguments orally, incorporating in their speech language resources to express and make their ideas understand. This in-depth study promoted, through the implementation of the didactic sequence as a pedagogical strategy, the transformation of the discursive processes in the classroom as a scenario of interaction and dialogue, thus favoring the empowerment of the word, the construction of knowledge and being a citizen

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Programa de investigación para la enseñanza y potenciación de procesos cognoscitivos superiores, formas dinámicas de aprendizaje y ordenamiento de la actividad de estudio.

IP 1115-11-043-95v.1. La Educación de la inteligencia como conocimiento autorregulado : enseñanza y aprendizaje metacognitivos de la fisica / Egidio Lopera E. ; coinvestigadores: Jorge Antonio Mejia, Rodrigo Covaleda, Gloria Amparo Arias. -- v.2. Enseñanza cognitiva y estrategicaen cienciasnaturales para lograr la habilidad de solucion de problemas de contaminacion ambiental / Egidio Lopera E. ; coinvestigadores: Jorge Antonio Mejia, Alicia Uribe Toro, Claudia Maria Bustamante, Ruth ElenaQuiroz, AnaElsy Diaz. -- v.3. Enseñanza y aprendizaje metacognitivos de la apreciacion de las obrasde arte / EgidioLopera E. ; Carlos A. Fernandez, Jorge A. Mejia, Gloria P. Zapata, Claudia P. San Nicolas,DuberM. Echavarria. -- v.4. El cultivo de la razon y del dialogo para la solucion de problemas de convivenciaescolar / Egidio Lopera E. ; coinvestigadores: Jorge Antonio Mejia E., Patricia Parra Moncada, Sandra ValenciaRuiz. -- v.5. La Educación de la inteligencia como potencialidad y resignificacion social de la diversidad.Primera Parte: Activacion cognitiva de la zona de desarrollo proximo en niños con retardo mental moderado/ Egidio LoperaE. ; coninvestigadores: Jorge Antonio Mejia, Luz Estella Giraldo, Maribel Medina Medina,LibiaVelez Latorre. -- Segunda Parte: Entrenamiento a niños con retardo mental leve en estrategias deelaboracion y habilidades cognitivas de observacion y representacion para la comprension de las relaciones interpersonales en el ambito escolar / Egidio Lopera E. ; coinvestigadores: Jorge Antonio Mejia E., Edilma MarinDiaz, Mercedes Jaramillo Blandon.LIBRO(S): El cultivo de la razon etica y del dialogo parala solucion de problemas de convivencia escolar /;investigadores: Egidio Lopera E., Jorge Antonio Mejia E. ;coinvestigadoras: Edilma Marin Diaz, Patricia Parra;Enseñanza cognitiva y estrategica en ciencias naturales para lograr la habilidad de resolucion de problemas de;contaminacion ambiental, con estudiantes de cuarto grado de basica primaria / investigadores: Egidio Lopera;E., Alicia Uribe Toro, Jorge Antonio Mejia E. ; coinvestigadores: Ana ElsyDiaz, Ruth Elena Quiroz, Claudia;Bustamante. -- Medellin : Universidad de Antioquia, 2002.'-- 132p. : il.; 24 cm. -- ISBN 958655614X.;M., Sandra Eugenia Valencia R. -- Medellin : Universidad de Antioquia, 2002. -- 126 p. : il. ; 24 cm. -- ISBN;9586555976 -- Aprendizaje metacognitivo de la fisica parael analisis conceptual y procedimental en la;resolucion de problemas / investigadores: Egidio Lopera E., Rodrigo Covaleda, Jorge Antonio Mejia E. ;coinvestigadora: Gloria Amparo Arias. -- Medellin : Universidadde Antioquia, 2002. -- 116 p. : il. ; 24 cm.; ISBN 9586555933 -- Entrenamiento a niños con retraso mentalleve en estrategias de elaboracion y;habilidades cognitivas de observacion y representacion para lacomprensionde las relaciones enterpersonales;en el ambito escolar / investigadores: Egidio Lopera E. ... [etal.]. -- Medellin : Universidad de Antioquia,;2003. -- 108 p. : il. ; 24 cm. -- ISBN 9586556158 -- Activacioncognitivade la zona de desarrollo proximo en;niños con retardo mental moderado / investigadores: EgidioLopera E., Jorge Antonio Mejia ; coinvestigadores:;Luz Estella Giraldo, Maribel Medina Medina, Libia Velez Latorre.'-- Medellin : Universidad de Antioquia, 2002.; 171 p. : il. ; 24 cm. -- ISBN 958655600X -- Enseñanza metacognitiva dela apreciacion de obras de arte para;el logro del razonamiento critico aplicado / investigadores: Egidio LoperaE., Carlos Arturo Fernandez, Jorge;Antonio Mejia E. ; coinvestigadoras: Gloria Patricia Zapata, Claudia Patricia San Nicolas, Duber Mary;Echavarria. -- Medellin : Universidad de Antioquia, 2002.'-- 115p. : il.; 24 cm. -- ISBN 9586555666 -

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN