Formas de diseño: de los objetos a las cosas

We can affirm that one of the vectors of configuration of contemporary space took shape in the liberation of the elements from each other in a process of conversion of the immovable into furniture. Artifacts, objects or furniture thus acquired the status of autonomy with respect to the built, consolidating a mechanism of spatial definition that identifies uses with added objects (machines, furniture, decoration). The recent renunciation of the utilitarian condition of these objects and the vindication of their mediating role in the relationship with the subjects has served to establish the appearance of an alternative variable of topological organization of space: things. Podemos afirmar que uno de los vectores de configuración del espacio contemporáneo se concretó en la liberación de los elementos entre sí en un proceso de conversión de lo inmueble en mueble. Los artefactos, objetos o muebles adquirieron así estatuto de autonomía respecto a lo construido consolidando un mecanismo de definición espacial que identifica los usos con los objetos añadidos (máquinas, muebles, decoración). La reciente renuncia a la condición utilitarista de dichos objetos y la reivindicación de su papel mediador en la relación con los sujetos ha servido para instaurar la aparición de una variable alternativa de organización topológica del espacio, las cosas.

CUT-UP CITY. El ready-made como experimento urbano. (www.cutupcity.com)

CUT-UP es un término acuñado por el escritor estadounidense William S. Burroughs basado en la yuxtaposición de pasajes de las obras del propio autor y también de obras de otros escritores para luego volver a ensamblar los fragmentos de forma aleatoria generando sentidos y significados totalmente inéditos. Trasladado al campo de la arquitectura, el propósito de esta operación sería la de definir estrategias que, utilizando las formas existentes, consiguieran efectos completamente diferentes. Así, se puede decir que las nociones de originalidad e incluso de creación, tan presentes en nuestra cultura, se podrían entender de una manera mucho más libre y desprejuiciada.CUT-UP is a term coined by the American writer William S. Burroughs based on the juxtaposition of passages from the own works and also from others in order to re-assemble the random fragments generating completly new senses and meanings. Moved to architecture, the purpose of this operation would be to define strategies, using existing forms, to realise completely different effects. So, we can say that the notions of originality, and even creation, so present in our culture, could be understood in a more freely and unprejudiced way

Risk of infections in patients with NAFLD and Type 2 Diabetes under treatment with SGLT2 inhibitors and relationship with liver outcomes: A retrospective case-control study

Hepatic outcomes; Infections; Sodium-glucose co-transporter-2 inhibitorsResultados hepáticos; Infecciones; Inhibidores del cotransportador de sodio-glucosa-2Resultats hepàtics; Infeccions; Inhibidors del cotransportador de sodi-glucosa-2Introduction: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in developed countries, with its incidence growing parallel to the epidemics of obesity and type 2 diabetes mellitus (T2DM). Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are becoming a cornerstone in the management of cardiovascular health and some studies suggest the potential role in NAFLD. However, patients under treatment with SGLT2i are at risk of developing genitourinary fungal infections (GFIs). Moreover, both NAFLD and SGLT2i have a strong influence on the immune system, and therefore the risk of infections other than GFIs could be increased in NAFLD patients treated with SGLT2i. We aimed to examine the possible association of SGLT2i with infections and hepatic outcomes in NAFLD patients. Methods: We conducted a case-control study including NAFLD patients with T2DM visited at the Liver Unit outpatient clinic from 2016 to 2021 with a minimum follow-up of 6 months by selecting 65 patients receiving SGLT2i and 130 matched patients with other types of antidiabetic treatment. Results: During follow-up, GFIs were significantly higher in the SGLT2i group (15.4% vs. 3.8%; p=0.008), whereas there were no differences in the occurrence of overall infections (41.5% vs. 30%; p=0.1) nor in other types of specific infections. In the multivariable analysis, treatment with SGLT2i was not independently associated with higher odds of overall infection. On the other hand, SGLT2i patients showed a significantly lower incidence of hepatic events (1.5% vs. 10.7%; p=0.02). There were no significant different in all-cause mortality between cases and controls. Conclusions: NAFLD patients with T2DM receiving SGLT2i more frequently presented GFIs, whereas the incidence of other types of infections was not found to be higher than in other patients with NAFLD and T2DM treated with other drugs. Moreover, SGLT2i-treated patients had a lower occurrence of hepatic events. Further studies are warranted to validate our data.Funds from European Commission/EFPIA IMI2 853966-2, IMI2 777377, H2020 847989, and ISCIII PI19/01898

An imported case of vaccine-derived poliovirus type 2, Spain in the context of the ongoing polio Public Health Emergency of International Concern, September 2021

The monthly retrospective search for unreported acute flaccid paralysis (AFP) cases conducted as a complementary component of the Spanish AFP surveillance system identified a case of AFP in a child admitted in Spain from Senegal during August 2021. Vaccine-derived poliovirus 2 was identified in the stool in September 2021. We present public health implications and response undertaken within the framework of the National Action Plan for Polio Eradication and the Public Health Emergency of International Concern.S

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

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

24 galerías, un museo: la encuesta como instrumento de diseño

ResumenA mediados de los años setenta, en Madrid, es posible identificar una serie de experiencias que fueron más allá de la práctica arquitectónica tradicional, de los dominios establecidos de la academia y de la dinámica habitual de las actividades editoriales e institucionales. Las galerías de arte, con sus publicaciones, comisarios, coleccionistas, críticos y visitantes, resultaron un escenario prolífico para una red informal de agentes e instituciones que, a través de la programación de eventos de diversos formatos, instituyeron una mediación activa en la formación crítica de la ciudadanía. El seminario “Nuevos Comportamientos Artísticos”, celebrado en el Instituto Alemán de Madrid a lo largo de 1974, fue uno de estos acontecimientos. Su galería resultó ser pionera en la muestra de prácticas vinculadas al arte y al diseño, que promovían abiertamente su expansión hacia otros campos del conocimiento amparadas en una interpretación local de lo que se bautizó en España como “arte de concepto”. La acción ‘Encuesta a 24 galerías de Arte de Madrid’ con la que el colectivo multidisciplinar Grup de Treball (GdT) contribuyó en dicho seminario, sirve aquí para ilustrar la activación de esta red de galerías como un ‘contra-proyecto’. Un acto de diseño, apoyándose en la definición que Peter Eisenman hace de la ‘Arquitectura Conceptual’, que trasciende a lo artístico y lo contestatario para ofrecer una alternativa. La exposición de la encuesta y el conjunto de datos que se extraen de ella, acumulan los valores de lenguaje, interfaz, plataforma y medio necesarios para redefinir el marco de relaciones entre sus participantes y conformar en su asociación una comunidad con la capacidad de ser un Museo. Una institución inmaterial, fragmentaria y heterogénea que cuestiona las relaciones convencionales entre el arte, la ciudadanía y el mercado.AbstractIn the mid-1970s in Madrid, it’s possible to identify a series of experiences that went beyond traditional architectural practice, the established domains of academia and the usual dynamics of editorial and institutional activities. The art galleries, with their publications, curators, collectors, critics and visitors, proved to be a prolific setting for an informal network of agents and institutions that, through programming events of various formats, instituted an active mediation in the critical formation of the citizenry. The seminar “Nuevos Comportamientos Artísticos” (“New Artistic Behaviors”), held at the Madrid’s German Institute in 1974, was one of these events. Its gallery proved to be a pioneer in the exhibition of practices linked to art and design, which openly promoted their expansion into other fields of knowledge based on a local interpretation of what was noticed in Spain as “conceptual art”. The action “Survey of 24 art galleries in Madrid,” was the contribution to the seminar of the multidisciplinary collective Grup de Treball (GdT), and serves here to illustrate the activation of this network of galleries as a ‘counter-project’. An act of design, based on Peter Eisenman’s definition of ‘Conceptual Architecture’, that transcends art and controversies to offer an alternative. The exhibition of the survey’s answers accumulated the values of language, interface, platform and medium necessary to redefine the framework of relations between its participants. Whose association gathered a community with the capacity to be a Museum: a dematerialized, fragmented and heterogeneous institution that challenged conventional relationship between art, citizenry and the market