El proceso de resignificación de la praxis docente y curricular desde la perspectiva de la implementación de los proyectos pedagógicos productivos

This investigative process around the search for resignification of the teaching and curricular praxis from the perspective of the implementation of productive pedagogical projects, constitutes a valuable scenario, in a school context nuanced by curricular fragmentation and traditional pedagogical practices, which They have been generating a certain type of demotivation in students, a situation that is reflected in the marked disinterest of young people in their life project and the low results in external tests. Taking as theoretical referents productive pedagogical projects, project-based learning and matters concerning curricular theory, looking for key clues to support this process; all this framed in a methodological design enlightened by the qualitative approach, the hermeneutical historical paradigm and the ethnographic method, applying some instruments to the teachers focused on this investigative process, such as the survey and the interview, taking advantage of the different digital platforms taking into account the limitations imposed on the direct interaction with the actors caused by the pandemic that is hitting the planet at the present time. The research yielded some very important results in the framework of institutional resignification, especially in the teaching practice and in the curriculum, to the extent that through the same research, teachers review their pedagogical practices, adjusting them more to the needs of the student. moment and of course to those caused by the current health emergency, and in the resignification of the curriculum, a process of displacement from the disciplinary and closed perspective towards an interdisciplinary curriculum begins, having as a transversal axis the productive pedagogical projects.Este proceso investigativo alrededor de la búsqueda de resignificación de la praxis docente y curricular desde la perspectiva de la implementación de los proyectos pedagógicos productivos, se constituye en un escenario valioso, en un contexto escolar matizado por la fragmentación curricular y unas prácticas pedagógicas tradicionales, que vienen generando cierto tipo de desmotivación en los estudiantes, situación que se refleja en el desinterés marcado de los jóvenes por su proyecto de vida y los bajos resultados en las pruebas externas. Teniendo como referentes teóricos los proyectos pedagógicos productivos, el aprendizaje basado en proyectos y lo concerniente a la teoría curricular, buscando pistas claves para fundamentar este proceso; todo esto enmarcado en un diseño metodológico iluminado por el enfoque cualitativo, el paradigma histórico hermenéutico y el método etnográfico, aplicando unos instrumentos a los docentes focalizados en este proceso investigativo, tales como la encuesta y la entrevista, aprovechando las diferentes plataformas digitales teniendo en cuenta las limitaciones impuestas en la interacción directa con los actores originadas por la pandemia que azota al planeta en los actuales momentos. La investigación arrojo unos resultados muy importantes en el marco de la resignificación institucional, sobre todo en la praxis docente y en la curricular, en la medida que a través de la misma investigación, los docentes revisan sus prácticas pedagógicas, ajustándolas más a las necesidades del momento y por supuesto a las provocadas por la actual emergencia sanitaria, y en resignificación del currículo se inicia un proceso de desplazamiento desde la mirada disciplinar y cerrada hacia un currículo interdisciplinar, teniendo como eje transversal los proyectos pedagógicos productivos

Commonwealth of Massachusetts Mill Building Repurposing Pilot Project (Twist Mill - Athol, MA)

The purpose of the UMass Amherst Department of Landscape Architecture and Regional Planning’s participation in this project is to establish a redevelopment action plan that incorporates the ownership’s clear vision for reuse of the site, proposes solutions to various obstacles that have hindered progress, and serves as a guiding model in terms of improving the feasibility of similar projects throughout the state. The project team gathered information from a variety of resources, and conducted three distinct phases of analysis in order to complete this redevelopment action plan. The Phase I: Inventory examines the physical, regulatory, and financial context surrounding the current site in order to gauge its condition as a viable location to foster desired economic development for the region. The Phase II: Assessment utilizes these inventory findings to identify clear challenges that impact the redevelopment potential of the site in an effort to reduce overall project roadblocks. The Phase III: Implementation provides strategies to alleviate these challenges moving forward, in the form of clear recommendations for local, regional, and state level regulatory improvements. Phases I and II were conducted in the fall of 2013, and Phase III was conducted in the spring of 2014. Particular thanks for guidance on this project are extended to L.P. Athol Corporation ownership, Dr. John Mullin of the UMass Amherst Center for Economic Development, State Representative Denise Andrews of the Franklin County Second District, State Senator Stephen Brewer, State Senator Stanley Rosenberg, Congressman James McGovern, and the Town of Athol

Boletín NUESTRA AMÉRICA XXI - Desafíos y alternativas, num.73, Noviembre 2022

Nuestra América XXI : desafíos y alternativas #73 / Bruno Rodríguez Parrilla ... [et al.]; coordinación general de Alejandro César López Bolaños ; Gabriela Roffinelli; editado por Josefina Morales ... [et al.]. - 1a ed. - Ciudad Autónoma de Buenos Aires : CLACSO, 2022. Libro digital, PDF - (Boletines de grupos de trabajo) Archivo Digital: descarga y online ISBN 978-987-813-356-0 1. Inflación. 2. Crisis. 3. Geopolítica. I. Rodríguez Parrilla, Bruno. II. López Bolaños, Alejandro César, coord. III. Roffinelli, Gabriela, coord. IV. Morales, Josefina, ed. CDD 306.

Boletín NUESTRA AMÉRICA XXI - Desafíos y alternativas, num.72, Octubre 2022

Nuestra América XXI : desafíos y alternativas #73 / Bruno Rodríguez Parrilla ... [et al.]; coordinación general de Alejandro César López Bolaños ; Gabriela Roffinelli; editado por Josefina Morales ... [et al.]. - 1a ed. - Ciudad Autónoma de Buenos Aires : CLACSO, 2022. Libro digital, PDF - (Boletines de grupos de trabajo) Archivo Digital: descarga y online ISBN 978-987-813-356-0 1. Inflación. 2. Crisis. 3. Geopolítica. I. Rodríguez Parrilla, Bruno. II. López Bolaños, Alejandro César, coord. III. Roffinelli, Gabriela, coord. IV. Morales, Josefina, ed. CDD 306.

Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort.

Objectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, valid mRSS at 12±3 months after baseline and ≥1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS >5 and ≥25% from baseline to 12±3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline ≥10% (53.6% vs 34.4%; p<0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (≤22/51) or short disease duration (≤15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline ≥10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

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

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701